Pulmonary Aspergillosis in AIDS

To the Editor: According to Denning et al. (March 7 issue),¹ the presence of the acquired immunodeficiency syndrome (AIDS) does not appear to alter the accepted risk factors for aspergillosis (neutropenia and cortisone therapy^2,3) or the course of opportunistic aspergillosis, which includes invasive pulmonary, disseminated, and tracheobronchial forms that can cause obstruction.^4,5 Contrary to the claims of Denning et al., obstructing bronchial aspergillosis without anatomical abnormalities is an established entity^6,7 that has recently been reviewed.⁸ Also in contrast to Denning's report, broad-spectrum antibiotics and marijuana are not established risk factors for aspergillosis. When appropriately analyzed, antibiotics have been shown.