BMJ  2003;327:1405 (13 December), doi:10.1136/bmj.327.7428.1405

Letter

Real time assay of Aspergillus should be used in SARS patients receiving corticosteroids

The first 150 words of the full text of this article appear below.

EDITOR—No consensus currently exists on treatment of the severe acute respiratory syndrome (SARS). Wong et al reported that all patients with SARS received broad spectrum antibiotics and a combination of ribavirin and prednisolone.1 Intravenous methylprednisolone at high dosage was used in patients with respiratory distress or progressive consolidations in a chest radiograph.

However, the treatment of SARS with ribavarin and corticosteroids remains controversial.2 Corticosteroids are administered to suppress a possible cytokine storm, which may worsen the lung injury caused by the infectious agent.2 But using corticosteroids with possibly ineffective antiviral agents in patients with virus induced pneumonitis can be hazardous.2

If corticosteroids are administered doctors must always be aware of complications such as superinfections with Aspergillus,3 a known complication in any patient receiving corticosteroids.4 Patients with SARS receiving corticosteroids should therefore be monitored for aspergillosis.

Since Aspergillus usually grows slowly on culture (taking up to six days) and . . . [Full text of this article]

Ya Ping Wu, researcher

Department of Haematology, University Medical Centre Utrecht, 3584CX Utrecht, Netherlands ywu@azu.nl

Ran Wei, professor

Basic Medical Science Institute, Taishan Medical College, Taian, Shandong, China 271000

Jan Verhoef, professor

Eijkman-Winkler Centre for Medical Microbiology, Infectious Diseases and Inflammation, University Medical Centre Utrecht


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Relevant Article

Haematological manifestations in patients with severe acute respiratory syndrome: retrospective analysis
Raymond S M Wong, Alan Wu, K F To, Nelson Lee, Christopher W K Lam, C K Wong, Paul K S Chan, Margaret H L Ng, L M Yu, David S Hui, John S Tam, Gregory Cheng, and Joseph J Y Sung
BMJ 2003 326: 1358-1362. [Abstract] [Full Text] [PDF]

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