Description of Invasive Aspergillosis in Mexican Patients with Chronic Granulomatous Disease

Introduction In chronic granulomatous disease (CGD), Aspergillus is the most common cause of invasive fungal infections and accounts for a high percentage of mortality. Methods The current study included 45 patients with a genetic diagnosis of CGD recruited between 2005 and 2024 from seven public hospitals in four Mexican cities. Results We recruited 45 patients of CGD with invasive aspergillosis (IA) events. The median age between the first CGD manifestation and first aspergillosis event was 65 months. Mortality rate was 57.7% for proven aspergillosis events, 23.1% for probable events, and 19.2% for possible events (p = 0.038). Aspergillus fumigatus was the most common species. Of the 45 patients, 26 (58%) had one IA event, nine (20%) had two, five (11%) had three, and five (11%) had four IA events. The median time between the first and second events was 35 months (15–65), between the second and third events was 26 months (17.5–32.5), and between the third and fourth events was 22 months (15.5–43.5). Of the 78 IA events, 43 (55%) were treated with monotherapy, 16 (20.5%) with dual therapy, 15 (19.2%) with triple therapy, three (3.8%) with quadruple therapy, and one (1.5%) with quintuple therapy. Twenty-six (58%) of the 45 patients died, out of which 18 (69%) had IA. The median age at death was 107.5 months (44.7–196). Overall survival of the 45 patients was 80.8% at 64 months. Conclusions The high mortality rate of IA in CGD patients could be reduced by early suspicion, initiating correct antifungal treatment over a long period, and considering the performance of hematopoietic stem cell transplantation.