Invasive aspergillosis treated with adjunctive hyperbaric oxygenation: a retrospective clinical series at a single institution

BACKGROUND: Invasive aspergillosis is the leading cause of early death in many transplant centers and has a major impact on the management of hematologic malignancies. The mortality rate with current therapy (amphotericin B and surgery) has remained unacceptably high. In vitro data along with a few case reports have suggested a potential benefit of hyperbaric oxygen (HBO). METHODS: We retrospectively studied all patients referred to our service when histologic specimens suggested invasive aspergillosis. Our main assessment of outcome was survival 3 months after initiation of HBO. RESULTS: Ten patients were included. All received adjunctive HBO along with the standard of care. Rhinosinusinal infection was the primary presentation. The most common underlying conditions were hematologic malignancies. Six patients were free of signs of infection 3 months after the first HBO treatment. CONCLUSIONS: Adjunctive HBO appears to be a valuable tool in this devastating condition. Further studies are warranted to clarify its role.