tetano
Editor, Senior Moderator
Clin Respir J. 2019 Jan 20. doi: 10.1111/crj.12995. [Epub ahead of print]
[h=1]Invasive Pulmonary Aspergillosis in Patients with Influenza Infection: A Retrospective Study and Review of the Literature.[/h] Huang L[SUP]1[/SUP], Zhang N[SUP]1,[/SUP][SUP]2[/SUP], Huang X[SUP]1[/SUP], Xiong S[SUP]1[/SUP], Feng Y[SUP]1[/SUP], Zhang Y[SUP]1[/SUP], Li M[SUP]1[/SUP], Zhan Q[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]INTRODUCTION:[/h] There has been a rapid increase in the number of influenza and invasive pulmonary aspergillosis (IPA) co-infection.
[h=4]OBJECTIVES:[/h] To explore the risk factors and predictors of a poor prognosis in influenza and IPA co-infection.
[h=4]METHODS:[/h] We included patients with confirmed influenza during the 2017 to 2018 influenza season and cases of influenza and IPA co-infection in the literature.
[h=4]RESULTS:[/h] A total of 64 patients with influenza infection were admitted to ICU. Of these patients, 18 were co-infected with IPA. Others were assigned to the control group (n=46). A total of 45 patients from the literature were added to the IPA group (n=63). A multivariate logistic regression suggested that influenza patients who were given steroids after ICU admission, who had a WBC of more than 10*10^9/L on ICU admission, and whose CT findings manifested as multiple nodules and cavities might have a higher risk of developing IPA. Compared to survivors, non-survivors had higher SOFA scores (16?4 points vs. 8?4 points, P<0.001), lower CD[SUB]4[/SUB] [SUP]+[/SUP] T cell counts on ICU admission [315 (83-466) cells/μl vs. 152 (50-220) cells/μl, P=0.031] and more requirement ECMO support [13 (50%) vs. 7 (18.9%), P=0.015].
[h=4]CONCLUSIONS:[/h] Influenza patients who are given steroids after ICU admission, who have WBCs of greater than 10*10^9/L on ICU admission, and whose CT imaging shows multiple nodules and cavities might have a high risk of IPA. Higher SOFA scores, CD[SUB]4[/SUB] [SUP]+[/SUP] T cell counts lower than 200 cells/μl on ICU admission and more ECMO requirement might be predictors of a poor prognosis. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
[h=4]KEYWORDS:[/h] Clinical presentations; Influenza; Invasive pulmonary aspergillosis (IPA); Prognosis; Risk factor
PMID: 30661296 DOI: 10.1111/crj.12995
[h=1]Invasive Pulmonary Aspergillosis in Patients with Influenza Infection: A Retrospective Study and Review of the Literature.[/h] Huang L[SUP]1[/SUP], Zhang N[SUP]1,[/SUP][SUP]2[/SUP], Huang X[SUP]1[/SUP], Xiong S[SUP]1[/SUP], Feng Y[SUP]1[/SUP], Zhang Y[SUP]1[/SUP], Li M[SUP]1[/SUP], Zhan Q[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]INTRODUCTION:[/h] There has been a rapid increase in the number of influenza and invasive pulmonary aspergillosis (IPA) co-infection.
[h=4]OBJECTIVES:[/h] To explore the risk factors and predictors of a poor prognosis in influenza and IPA co-infection.
[h=4]METHODS:[/h] We included patients with confirmed influenza during the 2017 to 2018 influenza season and cases of influenza and IPA co-infection in the literature.
[h=4]RESULTS:[/h] A total of 64 patients with influenza infection were admitted to ICU. Of these patients, 18 were co-infected with IPA. Others were assigned to the control group (n=46). A total of 45 patients from the literature were added to the IPA group (n=63). A multivariate logistic regression suggested that influenza patients who were given steroids after ICU admission, who had a WBC of more than 10*10^9/L on ICU admission, and whose CT findings manifested as multiple nodules and cavities might have a higher risk of developing IPA. Compared to survivors, non-survivors had higher SOFA scores (16?4 points vs. 8?4 points, P<0.001), lower CD[SUB]4[/SUB] [SUP]+[/SUP] T cell counts on ICU admission [315 (83-466) cells/μl vs. 152 (50-220) cells/μl, P=0.031] and more requirement ECMO support [13 (50%) vs. 7 (18.9%), P=0.015].
[h=4]CONCLUSIONS:[/h] Influenza patients who are given steroids after ICU admission, who have WBCs of greater than 10*10^9/L on ICU admission, and whose CT imaging shows multiple nodules and cavities might have a high risk of IPA. Higher SOFA scores, CD[SUB]4[/SUB] [SUP]+[/SUP] T cell counts lower than 200 cells/μl on ICU admission and more ECMO requirement might be predictors of a poor prognosis. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
[h=4]KEYWORDS:[/h] Clinical presentations; Influenza; Invasive pulmonary aspergillosis (IPA); Prognosis; Risk factor
PMID: 30661296 DOI: 10.1111/crj.12995