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Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China
BACKGROUND: The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria are widely used in the diagnosis of invasive pulmonary aspergillosis (IPA), but they only apply to immunocompromised patients. We here aimed to identify clinical characteristics helpfu...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341597/ https://www.ncbi.nlm.nih.gov/pubmed/32635916 http://dx.doi.org/10.1186/s12931-020-01424-x |
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author | Liu, Zhibo Li, Yuping Tian, Xinlun Liu, Qinghua Li, Erran Gu, Xiaoying Liu, Min Xu, Jiuyang He, Zhiyi Huang, Yi Xu, Shuyun Lai, Guoxiang Chen, Yusheng Zhang, Xiangyan Zhang, Tiantuo Xu, Jinfu Zhu, Lanyan Qu, Jieming Cao, Bin |
author_facet | Liu, Zhibo Li, Yuping Tian, Xinlun Liu, Qinghua Li, Erran Gu, Xiaoying Liu, Min Xu, Jiuyang He, Zhiyi Huang, Yi Xu, Shuyun Lai, Guoxiang Chen, Yusheng Zhang, Xiangyan Zhang, Tiantuo Xu, Jinfu Zhu, Lanyan Qu, Jieming Cao, Bin |
author_sort | Liu, Zhibo |
collection | PubMed |
description | BACKGROUND: The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria are widely used in the diagnosis of invasive pulmonary aspergillosis (IPA), but they only apply to immunocompromised patients. We here aimed to identify clinical characteristics helpful to the diagnosis of IPA in non-immunocompromised patients. METHODS: This is a multicenter retrospective study. Data were collected from adult patients with IPA admitted to 15 tertiary hospitals in China from 2010 to 2016. RESULTS: We included 254 patients in the study, of whom 66 (26.0%) were immunocompromised, and 188 (74.0%) were not. Airway-invasion-associated computed tomography (CT) signs including patchy exudation along the airway (67.6% vs. 45.5%, P = 0.001) and thickened airway wall (42.0% vs. 16.7%, P < 0.001) were more common in non-immunocompromised patients than in immunocompromised ones, and angio-invasive CT signs were more common in immunocompromised patients (55.3% vs.72.7%, P = 0.013). Typical angio-invasive CT signs were delayed in non-immunocompromised IPA patients, whereas airway-invasive signs appear earlier. Host immunocompromised condition was associated with ICU admission and/or intubation (OR 1.095; 95% CI 1.461–6.122; P = 0.003). Poor prognosis (35.5% vs. 21.1%, P = 0.005) was more common in immunocompromised patients. CONCLUSION: Airway-invasion-associated CT presentations at early stages of the disease are characteristic of IPA in non-immunocompromised hosts. |
format | Online Article Text |
id | pubmed-7341597 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73415972020-07-14 Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China Liu, Zhibo Li, Yuping Tian, Xinlun Liu, Qinghua Li, Erran Gu, Xiaoying Liu, Min Xu, Jiuyang He, Zhiyi Huang, Yi Xu, Shuyun Lai, Guoxiang Chen, Yusheng Zhang, Xiangyan Zhang, Tiantuo Xu, Jinfu Zhu, Lanyan Qu, Jieming Cao, Bin Respir Res Research BACKGROUND: The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria are widely used in the diagnosis of invasive pulmonary aspergillosis (IPA), but they only apply to immunocompromised patients. We here aimed to identify clinical characteristics helpful to the diagnosis of IPA in non-immunocompromised patients. METHODS: This is a multicenter retrospective study. Data were collected from adult patients with IPA admitted to 15 tertiary hospitals in China from 2010 to 2016. RESULTS: We included 254 patients in the study, of whom 66 (26.0%) were immunocompromised, and 188 (74.0%) were not. Airway-invasion-associated computed tomography (CT) signs including patchy exudation along the airway (67.6% vs. 45.5%, P = 0.001) and thickened airway wall (42.0% vs. 16.7%, P < 0.001) were more common in non-immunocompromised patients than in immunocompromised ones, and angio-invasive CT signs were more common in immunocompromised patients (55.3% vs.72.7%, P = 0.013). Typical angio-invasive CT signs were delayed in non-immunocompromised IPA patients, whereas airway-invasive signs appear earlier. Host immunocompromised condition was associated with ICU admission and/or intubation (OR 1.095; 95% CI 1.461–6.122; P = 0.003). Poor prognosis (35.5% vs. 21.1%, P = 0.005) was more common in immunocompromised patients. CONCLUSION: Airway-invasion-associated CT presentations at early stages of the disease are characteristic of IPA in non-immunocompromised hosts. BioMed Central 2020-07-07 2020 /pmc/articles/PMC7341597/ /pubmed/32635916 http://dx.doi.org/10.1186/s12931-020-01424-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits 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/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Liu, Zhibo Li, Yuping Tian, Xinlun Liu, Qinghua Li, Erran Gu, Xiaoying Liu, Min Xu, Jiuyang He, Zhiyi Huang, Yi Xu, Shuyun Lai, Guoxiang Chen, Yusheng Zhang, Xiangyan Zhang, Tiantuo Xu, Jinfu Zhu, Lanyan Qu, Jieming Cao, Bin Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China |
title | Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China |
title_full | Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China |
title_fullStr | Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China |
title_full_unstemmed | Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China |
title_short | Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China |
title_sort | airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary aspergillosis in non-immunocompromised adults: a national multicenter retrospective survey in china |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341597/ https://www.ncbi.nlm.nih.gov/pubmed/32635916 http://dx.doi.org/10.1186/s12931-020-01424-x |
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