Invasive Pulmonary Aspergillosis in Nonimmunocompromised Hosts.

Abstract

Invasive pulmonary aspergillosis (IPA) is a fungal infection that is the hallmark of severe cellular or complex immune alterations. Evidence that IPA can occur in nonimmunocompromised hosts is increasing. Actually, up to 1% of general intensive care unit (ICU) patients present positive samples with Aspergillus spp. Both colonization and invasive disease are associated with poor outcome. Unexpected IPA has also been reported in approximately 1% of critically ill patients who underwent postmortem biopsies. In nonimmunocompromised patients with acute respiratory distress syndrome (ARDS), IPA prevalence can reach up to 15% of patients in both clinical and autopsy studies. Factors associated with IPA in nonimmunocompromised critically ill hosts include short and long courses of steroids, broad antibiotic therapy, chronic obstructive pulmonary disease, ARDS, liver failure, and the severity of organ dysfunctions.This review aims to appraise the prevalence of IPA in nonimmunocompromised hosts, address diagnostic challenges, and outcomes.

• Authors: Jean-Jacques Tudesq, Olivier Peyrony, Virginie Lemiale, Elie Azoulay
• Journal: Seminars in respiratory and critical care medicine (Semin Respir Crit Care Med) Vol. 40 Issue 4 Pg. 540-547 (08 2019) ISSN: 1098-9048 [Electronic] United States
• PMID: 31585479 (Publication Type: Journal Article, Review)
• Copyright: Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chemical References

• Antifungal Agents

Topics

• Antifungal Agents (therapeutic use)
• Critical Illness (therapy)
• Humans
• Immune Tolerance
• Immunocompromised Host
• Invasive Pulmonary Aspergillosis (diagnosis, drug therapy, mortality)
• Prevalence
• Pulmonary Disease, Chronic Obstructive (complications)
• Respiratory Distress Syndrome (complications)
• Risk Factors
• Sepsis (complications)