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Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition : an expert opinion

(2020) INTENSIVE CARE MEDICINE. 46(8). p.1524-1535
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Abstract
Purpose Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult, and our aim was to develop case definitions for IAPA that can facilitate clinical studies. Methods A group of 29 international experts reviewed current insights into the epidemiology, diagnosis and management of IAPA and proposed a case definition of IAPA through a process of informal consensus. Results Since IAPA may develop in a wide range of hosts, an entry criterion was proposed and not host factors. The entry criterion was defined as a patient requiring ICU admission for respiratory distress with a positive influenza test temporally related to ICU admission. In addition, proven IAPA required histological evidence of invasive septate hyphae and mycological evidence forAspergillus. Probable IAPA required the detection of galactomannan or positiveAspergillusculture in bronchoalveolar lavage (BAL) or serum with pulmonary infiltrates or a positive culture in upper respiratory samples with bronchoscopic evidence for tracheobronchitis or cavitating pulmonary infiltrates of recent onset. The IAPA case definitions may be useful to classify patients with COVID-19-associated pulmonary aspergillosis (CAPA), while awaiting further studies that provide more insight into the interaction betweenAspergillusand the SARS-CoV-2-infected lung. Conclusion A consensus case definition of IAPA is proposed, which will facilitate research into the epidemiology, diagnosis and management of this emerging acute and severeAspergillusdisease, and may be of use to study CAPA.
Keywords
Critical Care and Intensive Care Medicine, Viral pneumonia, Influenza, COVID-19, Invasive aspergillosis, ICU, INFECTIOUS-DISEASES SOCIETY, CRITICALLY-ILL PATIENTS, PRACTICE GUIDELINES, FUNGAL-INFECTIONS, VORICONAZOLE, MANAGEMENT, DIAGNOSIS, EFFICACY, SAFETY, VIRUS

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MLA
Verweij, Paul E., et al. “Review of Influenza-Associated Pulmonary Aspergillosis in ICU Patients and Proposal for a Case Definition : An Expert Opinion.” INTENSIVE CARE MEDICINE, vol. 46, no. 8, 2020, pp. 1524–35, doi:10.1007/s00134-020-06091-6.
APA
Verweij, P. E., Rijnders, B. J. A., Brüggemann, R. J. M., Azoulay, E., Bassetti, M., Blot, S., … van de Veerdonk, F. L. (2020). Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition : an expert opinion. INTENSIVE CARE MEDICINE, 46(8), 1524–1535. https://doi.org/10.1007/s00134-020-06091-6
Chicago author-date
Verweij, Paul E., Bart J. A. Rijnders, Roger J. M. Brüggemann, Elie Azoulay, Matteo Bassetti, Stijn Blot, Thierry Calandra, et al. 2020. “Review of Influenza-Associated Pulmonary Aspergillosis in ICU Patients and Proposal for a Case Definition : An Expert Opinion.” INTENSIVE CARE MEDICINE 46 (8): 1524–35. https://doi.org/10.1007/s00134-020-06091-6.
Chicago author-date (all authors)
Verweij, Paul E., Bart J. A. Rijnders, Roger J. M. Brüggemann, Elie Azoulay, Matteo Bassetti, Stijn Blot, Thierry Calandra, Cornelius J. Clancy, Oliver A. Cornely, Tom Chiller, Pieter Depuydt, Daniele Roberto Giacobbe, Nico A. F. Janssen, Bart-Jan Kullberg, Katrien Lagrou, Cornelia Lass-Flörl, Russell E. Lewis, Peter Wei-Lun Liu, Olivier Lortholary, Johan Maertens, Ignacio Martin-Loeches, M. Hong Nguyen, Thomas F. Patterson, Thomas R. Rogers, Jeroen A. Schouten, Isabel Spriet, Lore Vanderbeke, Joost Wauters, and Frank L. van de Veerdonk. 2020. “Review of Influenza-Associated Pulmonary Aspergillosis in ICU Patients and Proposal for a Case Definition : An Expert Opinion.” INTENSIVE CARE MEDICINE 46 (8): 1524–1535. doi:10.1007/s00134-020-06091-6.
Vancouver
1.
Verweij PE, Rijnders BJA, Brüggemann RJM, Azoulay E, Bassetti M, Blot S, et al. Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition : an expert opinion. INTENSIVE CARE MEDICINE. 2020;46(8):1524–35.
IEEE
[1]
P. E. Verweij et al., “Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition : an expert opinion,” INTENSIVE CARE MEDICINE, vol. 46, no. 8, pp. 1524–1535, 2020.
@article{8670312,
  abstract     = {{Purpose Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult, and our aim was to develop case definitions for IAPA that can facilitate clinical studies. Methods A group of 29 international experts reviewed current insights into the epidemiology, diagnosis and management of IAPA and proposed a case definition of IAPA through a process of informal consensus. Results Since IAPA may develop in a wide range of hosts, an entry criterion was proposed and not host factors. The entry criterion was defined as a patient requiring ICU admission for respiratory distress with a positive influenza test temporally related to ICU admission. In addition, proven IAPA required histological evidence of invasive septate hyphae and mycological evidence forAspergillus. Probable IAPA required the detection of galactomannan or positiveAspergillusculture in bronchoalveolar lavage (BAL) or serum with pulmonary infiltrates or a positive culture in upper respiratory samples with bronchoscopic evidence for tracheobronchitis or cavitating pulmonary infiltrates of recent onset. The IAPA case definitions may be useful to classify patients with COVID-19-associated pulmonary aspergillosis (CAPA), while awaiting further studies that provide more insight into the interaction betweenAspergillusand the SARS-CoV-2-infected lung. Conclusion A consensus case definition of IAPA is proposed, which will facilitate research into the epidemiology, diagnosis and management of this emerging acute and severeAspergillusdisease, and may be of use to study CAPA.}},
  author       = {{Verweij, Paul E. and Rijnders, Bart J. A. and Brüggemann, Roger J. M. and Azoulay, Elie and Bassetti, Matteo and Blot, Stijn and Calandra, Thierry and Clancy, Cornelius J. and Cornely, Oliver A. and Chiller, Tom and Depuydt, Pieter and Giacobbe, Daniele Roberto and Janssen, Nico A. F. and Kullberg, Bart-Jan and Lagrou, Katrien and Lass-Flörl, Cornelia and Lewis, Russell E. and Liu, Peter Wei-Lun and Lortholary, Olivier and Maertens, Johan and Martin-Loeches, Ignacio and Nguyen, M. Hong and Patterson, Thomas F. and Rogers, Thomas R. and Schouten, Jeroen A. and Spriet, Isabel and Vanderbeke, Lore and Wauters, Joost and van de Veerdonk, Frank L.}},
  issn         = {{0342-4642}},
  journal      = {{INTENSIVE CARE MEDICINE}},
  keywords     = {{Critical Care and Intensive Care Medicine,Viral pneumonia,Influenza,COVID-19,Invasive aspergillosis,ICU,INFECTIOUS-DISEASES SOCIETY,CRITICALLY-ILL PATIENTS,PRACTICE GUIDELINES,FUNGAL-INFECTIONS,VORICONAZOLE,MANAGEMENT,DIAGNOSIS,EFFICACY,SAFETY,VIRUS}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1524--1535}},
  title        = {{Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition : an expert opinion}},
  url          = {{http://doi.org/10.1007/s00134-020-06091-6}},
  volume       = {{46}},
  year         = {{2020}},
}

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