Invasive pulmonary aspergillosis in critically ill patients with hematological malignancies

Pardo, Emmanuel; Lemiale, Virginie; Mokart, Djamel; Stoclin, Annabelle; Moreau, Anne‐Sophie; Kerhuel, Lionel; Calvet, Laure; Valade, Sandrine; Jong, Audrey De; Darmon, Michaël; Azoulay, Élie

doi:10.1007/s00134-019-05789-6

Cited by 29 publications

(29 citation statements)

References 40 publications

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“…Prophylaxis could be discussed as for pulmonary aspergillosis in critically ill influenza patients ( 18 ), although no benefit was observed in critically ill influenza patients ( 19 ). For the patients with EORTC/MSGERC host factors and COVID-19, more than 75% of them died, which is worse than the 58.4% in ICU patients with hematological malignancies and invasive pulmonary aspergillosis ( 20 ). Antifungal prophylaxis could be proposed for patients with EORTC/MSGERC host factors and COVID-19 as after allogeneic stem cell transplantation or intensive chemotherapy ( 21 ).…”

Section: Discussionmentioning

confidence: 95%

COVID-19-Associated Pulmonary Aspergillosis, Fungemia, and Pneumocystosis in the Intensive Care Unit: a Retrospective Multicenter Observational Cohort during the First French Pandemic Wave

et al. 2021

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Section: Discussionmentioning

confidence: 95%

COVID-19-Associated Pulmonary Aspergillosis, Fungemia, and Pneumocystosis in the Intensive Care Unit: a Retrospective Multicenter Observational Cohort during the First French Pandemic Wave

et al. 2021

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“…Although survival has improved over time, IA remains an often fatal complication after HSCT. In a retrospective study of patients with hematological malignancies who developed ARF due to IA, 1-year mortality was 72% [99]. Mortality in transplant recipients was 49.4%, with a higher rate after HSCT (57.5%) than after SOT (34.4%) [100].…”

Section: Invasive Fungal Infectionsmentioning

confidence: 99%

Diagnosis of severe respiratory infections in immunocompromised patients

et al. 2020

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An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to create complex clinical pictures. In addition, there may be more than one infectious agent, and the pulmonary manifestations may be related to both infectious and non-infectious insults. Clinically or microbiologically documented bacterial pneumonia accounts for one-third of cases of ARF in immunocompromised patients. Early antibiotic therapy is recommended but decreases the chances of identifying the causative organism(s) to about 50%. Viruses are the second most common cause of severe respiratory infections. Positive tests for a virus in respiratory samples do not necessarily indicate a role for the virus in the current acute illness. Invasive fungal infections (Aspergillus, Mucorales, and Pneumocystis jirovecii) account for about 15% of severe respiratory infections, whereas parasites rarely cause severe acute infections in immunocompromised patients. This review focuses on the diagnosis of severe respiratory infections in immunocompromised patients. Special attention is given to newly validated diagnostic tests designed to be used on non-invasive samples or bronchoalveolar lavage fluid and capable of increasing the likelihood of an early etiological diagnosis.

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“…The overall and attributable mortality are high reaching up to 42% and 27%, respectively [4,5]. Invasive pulmonary aspergillosis (IPA) is associated with even higher mortality up to 75%, and it has been shown to negatively impact the long-term survival of leukemia patients [6,7].…”

Section: Introductionmentioning

confidence: 99%

Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients

Stemler

Bruns

Mellinghoff

et al. 2020

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Baseline chest computed tomography (BCT) in high-risk hematology patients allows for the early diagnosis of invasive pulmonary aspergillosis (IPA). The distribution of BCT implementation in hematology departments and impact on outcome is unknown. A web-based questionnaire was designed. International scientific bodies were invited. The estimated numbers of annually treated hematology patients, chest imaging timepoints and techniques, IPA rates, and follow-up imaging were assessed. In total, 142 physicians from 43 countries participated. The specialties included infectious diseases (n = 69; 49%), hematology (n = 68; 48%), and others (n = 41; 29%). BCT was performed in 57% (n = 54) of 92 hospitals. Upon the diagnosis of malignancy or admission, 48% and 24% performed BCT, respectively, and X-ray was performed in 48% and 69%, respectively. BCT was more often used in hematopoietic cell transplantation and in relapsed acute leukemia. European centers performed BCT in 59% and non-European centers in 53%. Median estimated IPA rate was 8% and did not differ between BCT (9%; IQR 5–15%) and non-BCT centers (7%; IQR 5–10%) (p = 0.69). Follow-up computed tomography (CT) for IPA was performed in 98% (n = 90) of centers. In high-risk hematology patients, baseline CT is becoming a standard-of-care. Chest X-ray, while inferior, is still widely used. Randomized, controlled trials are needed to investigate the impact of BCT on patient outcome.

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Invasive pulmonary aspergillosis in critically ill patients with hematological malignancies

Cited by 29 publications

References 40 publications

COVID-19-Associated Pulmonary Aspergillosis, Fungemia, and Pneumocystosis in the Intensive Care Unit: a Retrospective Multicenter Observational Cohort during the First French Pandemic Wave

COVID-19-Associated Pulmonary Aspergillosis, Fungemia, and Pneumocystosis in the Intensive Care Unit: a Retrospective Multicenter Observational Cohort during the First French Pandemic Wave

Diagnosis of severe respiratory infections in immunocompromised patients

Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients

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