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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-8780730 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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