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Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion
PURPOSE: Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306567/ https://www.ncbi.nlm.nih.gov/pubmed/32572532 http://dx.doi.org/10.1007/s00134-020-06091-6 |
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author | Verweij, Paul E. Rijnders, Bart J. A. Brüggemann, Roger J. M. Azoulay, Elie Bassetti, Matteo Blot, Stijn Calandra, Thierry Clancy, Cornelius J. Cornely, Oliver A. Chiller, Tom Depuydt, Pieter Giacobbe, Daniele Roberto Janssen, Nico A. F. Kullberg, Bart-Jan Lagrou, Katrien Lass-Flörl, Cornelia Lewis, Russell E. Liu, Peter Wei-Lun Lortholary, Olivier Maertens, Johan Martin-Loeches, Ignacio Nguyen, M. Hong Patterson, Thomas F. Rogers, Thomas R. Schouten, Jeroen A. Spriet, Isabel Vanderbeke, Lore Wauters, Joost van de Veerdonk, Frank L. |
author_facet | Verweij, Paul E. Rijnders, Bart J. A. Brüggemann, Roger J. M. Azoulay, Elie Bassetti, Matteo Blot, Stijn Calandra, Thierry Clancy, Cornelius J. Cornely, Oliver A. Chiller, Tom Depuydt, Pieter Giacobbe, Daniele Roberto Janssen, Nico A. F. Kullberg, Bart-Jan Lagrou, Katrien Lass-Flörl, Cornelia Lewis, Russell E. Liu, Peter Wei-Lun Lortholary, Olivier Maertens, Johan Martin-Loeches, Ignacio Nguyen, M. Hong Patterson, Thomas F. Rogers, Thomas R. Schouten, Jeroen A. Spriet, Isabel Vanderbeke, Lore Wauters, Joost van de Veerdonk, Frank L. |
author_sort | Verweij, Paul E. |
collection | PubMed |
description | PURPOSE: Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult, and our aim was to develop case definitions for IAPA that can facilitate clinical studies. METHODS: A group of 29 international experts reviewed current insights into the epidemiology, diagnosis and management of IAPA and proposed a case definition of IAPA through a process of informal consensus. RESULTS: Since IAPA may develop in a wide range of hosts, an entry criterion was proposed and not host factors. The entry criterion was defined as a patient requiring ICU admission for respiratory distress with a positive influenza test temporally related to ICU admission. In addition, proven IAPA required histological evidence of invasive septate hyphae and mycological evidence for Aspergillus. Probable IAPA required the detection of galactomannan or positive Aspergillus culture in bronchoalveolar lavage (BAL) or serum with pulmonary infiltrates or a positive culture in upper respiratory samples with bronchoscopic evidence for tracheobronchitis or cavitating pulmonary infiltrates of recent onset. The IAPA case definitions may be useful to classify patients with COVID-19-associated pulmonary aspergillosis (CAPA), while awaiting further studies that provide more insight into the interaction between Aspergillus and the SARS-CoV-2-infected lung. CONCLUSION: A consensus case definition of IAPA is proposed, which will facilitate research into the epidemiology, diagnosis and management of this emerging acute and severe Aspergillus disease, and may be of use to study CAPA. |
format | Online Article Text |
id | pubmed-7306567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-73065672020-06-22 Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion Verweij, Paul E. Rijnders, Bart J. A. Brüggemann, Roger J. M. Azoulay, Elie Bassetti, Matteo Blot, Stijn Calandra, Thierry Clancy, Cornelius J. Cornely, Oliver A. Chiller, Tom Depuydt, Pieter Giacobbe, Daniele Roberto Janssen, Nico A. F. Kullberg, Bart-Jan Lagrou, Katrien Lass-Flörl, Cornelia Lewis, Russell E. Liu, Peter Wei-Lun Lortholary, Olivier Maertens, Johan Martin-Loeches, Ignacio Nguyen, M. Hong Patterson, Thomas F. Rogers, Thomas R. Schouten, Jeroen A. Spriet, Isabel Vanderbeke, Lore Wauters, Joost van de Veerdonk, Frank L. Intensive Care Med Conference Reports and Expert Panel PURPOSE: Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult, and our aim was to develop case definitions for IAPA that can facilitate clinical studies. METHODS: A group of 29 international experts reviewed current insights into the epidemiology, diagnosis and management of IAPA and proposed a case definition of IAPA through a process of informal consensus. RESULTS: Since IAPA may develop in a wide range of hosts, an entry criterion was proposed and not host factors. The entry criterion was defined as a patient requiring ICU admission for respiratory distress with a positive influenza test temporally related to ICU admission. In addition, proven IAPA required histological evidence of invasive septate hyphae and mycological evidence for Aspergillus. Probable IAPA required the detection of galactomannan or positive Aspergillus culture in bronchoalveolar lavage (BAL) or serum with pulmonary infiltrates or a positive culture in upper respiratory samples with bronchoscopic evidence for tracheobronchitis or cavitating pulmonary infiltrates of recent onset. The IAPA case definitions may be useful to classify patients with COVID-19-associated pulmonary aspergillosis (CAPA), while awaiting further studies that provide more insight into the interaction between Aspergillus and the SARS-CoV-2-infected lung. CONCLUSION: A consensus case definition of IAPA is proposed, which will facilitate research into the epidemiology, diagnosis and management of this emerging acute and severe Aspergillus disease, and may be of use to study CAPA. Springer Berlin Heidelberg 2020-06-22 2020 /pmc/articles/PMC7306567/ /pubmed/32572532 http://dx.doi.org/10.1007/s00134-020-06091-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Conference Reports and Expert Panel Verweij, Paul E. Rijnders, Bart J. A. Brüggemann, Roger J. M. Azoulay, Elie Bassetti, Matteo Blot, Stijn Calandra, Thierry Clancy, Cornelius J. Cornely, Oliver A. Chiller, Tom Depuydt, Pieter Giacobbe, Daniele Roberto Janssen, Nico A. F. Kullberg, Bart-Jan Lagrou, Katrien Lass-Flörl, Cornelia Lewis, Russell E. Liu, Peter Wei-Lun Lortholary, Olivier Maertens, Johan Martin-Loeches, Ignacio Nguyen, M. Hong Patterson, Thomas F. Rogers, Thomas R. Schouten, Jeroen A. Spriet, Isabel Vanderbeke, Lore Wauters, Joost van de Veerdonk, Frank L. Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion |
title | Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion |
title_full | Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion |
title_fullStr | Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion |
title_full_unstemmed | Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion |
title_short | Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion |
title_sort | review of influenza-associated pulmonary aspergillosis in icu patients and proposal for a case definition: an expert opinion |
topic | Conference Reports and Expert Panel |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306567/ https://www.ncbi.nlm.nih.gov/pubmed/32572532 http://dx.doi.org/10.1007/s00134-020-06091-6 |
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