What host defense abnormality made him vulnerable to staphylococcal and aspergillus infections?

•  Chronic granulomatous disease is a condition in which neutrophil function is impaired as a result of defective production of superoxide radicals and intracellular killing of pathogens is impaired. 
• The administration of glucocorticoids further impair neutrophil function.
  
  

What is the epidemiology of Aspergillosis ? What are virulence characteristics of Aspergillus species? 

• Aspergillus species are ubiquitous, hence exposure is common. 
• Aspergillus fumigatus possesses extracellular inhibitors of the alternate complement pathway, and these impair opsonophagocytosis.
• Aspergillus species have a propensity for invading blood vessels leading to tissue infarction.
  
  

What is the utility of cultures in the diagnosis of Aspergillosis? 

•  Aspergillus is easy to grow ;cultures from respiratory specimens cannot distinguish colonization from invasive disease.
•  Histological demonstration of tissue invasion is required. 
• Aspergillus rarely grows in blood cultures even in cases of endocarditis.
  
  

What is the treatment of choice for aspergillosis? 

•  Amphotericin B in high doses remains the treatment of choice. 
• The addition of rifampin or 5FC may offer synergy. Itraconazole offers an alternative in non-life threatening aspergillosis. 
• Surgical removal of infarcted tissue may be necessary.