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Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019

This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factor...

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Autores principales: Wu, Chi-Jung, Cia, Cong-Tat, Wang, Hsuan-Chen, Chen, Chang-Wen, Lin, Wei-Chieh, Lee, Jen-Chieh, Chen, Po-Sheng, Hsieh, Chih-Cheng, Li, Wei-Ting, Su, Po-Lan, Liao, Xin-Min, Hsieh, Ming-I, Choi, Pui-Ching, Ko, Wen-Chien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780730/
https://www.ncbi.nlm.nih.gov/pubmed/35049989
http://dx.doi.org/10.3390/jof8010049
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author Wu, Chi-Jung
Cia, Cong-Tat
Wang, Hsuan-Chen
Chen, Chang-Wen
Lin, Wei-Chieh
Lee, Jen-Chieh
Chen, Po-Sheng
Hsieh, Chih-Cheng
Li, Wei-Ting
Su, Po-Lan
Liao, Xin-Min
Hsieh, Ming-I
Choi, Pui-Ching
Ko, Wen-Chien
author_facet Wu, Chi-Jung
Cia, Cong-Tat
Wang, Hsuan-Chen
Chen, Chang-Wen
Lin, Wei-Chieh
Lee, Jen-Chieh
Chen, Po-Sheng
Hsieh, Chih-Cheng
Li, Wei-Ting
Su, Po-Lan
Liao, Xin-Min
Hsieh, Ming-I
Choi, Pui-Ching
Ko, Wen-Chien
author_sort Wu, Chi-Jung
collection PubMed
description This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factors. The mean time from influenza diagnosis to Aspergillus growth was 4.4 days, and 20 (83.3%) developed IAPA within seven days after influenza diagnosis. All patients were treated in intensive care units and all but one (95.8%) received mechanical ventilation. Aspergillus tracheobronchitis was evident in 6 (31.6%) of 19 patients undergoing bronchoscopy. Positive galactomannan testing of either serum or bronchoalveolar lavage was noted in all patients. On computed tomography imaging, IAPA was characterized by peribronchial infiltrates, multiple nodules, and cavities superimposed on ground-glass opacities. Pure Aspergillus growth without bacterial co-isolation in culture was found in 17 (70.8%) patients. A. fumigatus (15, 62.5%), A. flavus (6, 25.0%), and A. terreus (4, 16.7%) were the major causative species. Three patients had mixed Aspergillus infections due to two species, and two had mixed azole-susceptible and azole-resistant A. fumigatus infection. All patients received voriconazole with an all-cause mortality of 41.6%. Of 14 survivors, the mean duration of antifungal use was 40.5 days. In conclusion, IAPA is an early and rapidly deteriorating complication following influenza that necessitates clinical vigilance and prompt diagnostic workup.
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spelling pubmed-87807302022-01-22 Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019 Wu, Chi-Jung Cia, Cong-Tat Wang, Hsuan-Chen Chen, Chang-Wen Lin, Wei-Chieh Lee, Jen-Chieh Chen, Po-Sheng Hsieh, Chih-Cheng Li, Wei-Ting Su, Po-Lan Liao, Xin-Min Hsieh, Ming-I Choi, Pui-Ching Ko, Wen-Chien J Fungi (Basel) Article This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factors. The mean time from influenza diagnosis to Aspergillus growth was 4.4 days, and 20 (83.3%) developed IAPA within seven days after influenza diagnosis. All patients were treated in intensive care units and all but one (95.8%) received mechanical ventilation. Aspergillus tracheobronchitis was evident in 6 (31.6%) of 19 patients undergoing bronchoscopy. Positive galactomannan testing of either serum or bronchoalveolar lavage was noted in all patients. On computed tomography imaging, IAPA was characterized by peribronchial infiltrates, multiple nodules, and cavities superimposed on ground-glass opacities. Pure Aspergillus growth without bacterial co-isolation in culture was found in 17 (70.8%) patients. A. fumigatus (15, 62.5%), A. flavus (6, 25.0%), and A. terreus (4, 16.7%) were the major causative species. Three patients had mixed Aspergillus infections due to two species, and two had mixed azole-susceptible and azole-resistant A. fumigatus infection. All patients received voriconazole with an all-cause mortality of 41.6%. Of 14 survivors, the mean duration of antifungal use was 40.5 days. In conclusion, IAPA is an early and rapidly deteriorating complication following influenza that necessitates clinical vigilance and prompt diagnostic workup. MDPI 2022-01-04 /pmc/articles/PMC8780730/ /pubmed/35049989 http://dx.doi.org/10.3390/jof8010049 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wu, Chi-Jung
Cia, Cong-Tat
Wang, Hsuan-Chen
Chen, Chang-Wen
Lin, Wei-Chieh
Lee, Jen-Chieh
Chen, Po-Sheng
Hsieh, Chih-Cheng
Li, Wei-Ting
Su, Po-Lan
Liao, Xin-Min
Hsieh, Ming-I
Choi, Pui-Ching
Ko, Wen-Chien
Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
title Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
title_full Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
title_fullStr Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
title_full_unstemmed Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
title_short Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
title_sort clinical and microbiological characteristics of culture-positive, influenza-associated pulmonary aspergillosis: a single-center study in southern taiwan, 2016–2019
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780730/
https://www.ncbi.nlm.nih.gov/pubmed/35049989
http://dx.doi.org/10.3390/jof8010049
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