Which algorithm diagnoses invasive pulmonary aspergillosis best in ICU patients with COPD?. Issue 3 (28th September 2017)

• Record Type: Journal Article
• Authors: Bulpa, Pierre; Bihin, Benoît; Dimopoulos, George; Taccone, Fabio S.; Van den Abeele, Anne-Marie; Misset, Benoît; Meersseman, Wouter; Spapen, Herbert; Cardoso, Teresa; Charles, Pierre-Emmanuel; Rello, Jordi; Vogelaers, Dirk; Blot, Stijn
• Is Part Of: European respiratory journal. Volume 50:Issue 3(2017)
• Publication Date: 2017-09-28
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00532-2017
• Languages: English
• ISSNs: 0903-1936

Abstract

Invasive pulmonary aspergillosis (IPA) is a potentially lethal opportunistic infection, mainly affecting immunocompromised patients, particularly those with prolonged neutropenia [1]. Several reports have shown that Aspergillus spp. can also cause IPA in patients with a priori less severe immune dysfunction, such as those in intensive care units (ICUs) [2–5] or with chronic obstructive pulmonary disease (COPD) [5–8]. In these patients, diagnosis of IPA remains a challenge, because the reference diagnostic criteria (defined by the European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG)) were developed for research in high-risk patients and not specifically for patients in the ICU or patients with COPD [9]. Two alternative algorithms have been proposed for this setting: the COPD algorithm for patients with COPD [6] and the Clinical algorithm for patients in the ICU [10]. In ICU COPD patients, the Clinical algorithm seems to be more useful to diagnose IPA than the COPD or EORTC/MSG ones http://ow.ly/N2TN30e6Zur