tetano
Editor, Senior Moderator
Lancet Respir Med
. 2024 Jul 15:S2213-2600(24)00151-6.
doi: 10.1016/S2213-2600(24)00151-6. Online ahead of print. Influenza-associated and COVID-19-associated pulmonary aspergillosis in critically ill patients
Simon Feys[SUP] 1 [/SUP], Agostinho Carvalho[SUP] 2 [/SUP], Cornelius J Clancy[SUP] 3 [/SUP], Jean-Pierre Gangneux[SUP] 4 [/SUP], Martin Hoenigl[SUP] 5 [/SUP], Katrien Lagrou[SUP] 6 [/SUP], Bart J A Rijnders[SUP] 7 [/SUP], Laura Seldeslachts[SUP] 8 [/SUP], Lore Vanderbeke[SUP] 9 [/SUP], Frank L van de Veerdonk[SUP] 10 [/SUP], Paul E Verweij[SUP] 11 [/SUP], Joost Wauters[SUP] 12 [/SUP]
Affiliations
Influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) are increasingly recognised as important complications in patients requiring intensive care for severe viral pneumonia. The diagnosis can typically be made in 10-20% of patients with severe influenza or COVID-19, but only when appropriate diagnostic tools are used. Bronchoalveolar lavage sampling for culture, galactomannan testing, and PCR forms the cornerstone of diagnosis, whereas visual examination of the tracheobronchial tract during bronchoscopy is required to detect invasive Aspergillus tracheobronchitis. Azoles are the first-choice antifungal drugs, with liposomal amphotericin B as an alternative in settings where azole resistance is prevalent. Despite antifungal therapy, IAPA and CAPA are associated with poor outcomes, with fatality rates often exceeding 50%. In this Review, we discuss the mechanistic and clinical aspects of IAPA and CAPA. Moreover, we identify crucial knowledge gaps and formulate directions for future research.
. 2024 Jul 15:S2213-2600(24)00151-6.
doi: 10.1016/S2213-2600(24)00151-6. Online ahead of print. Influenza-associated and COVID-19-associated pulmonary aspergillosis in critically ill patients
Simon Feys[SUP] 1 [/SUP], Agostinho Carvalho[SUP] 2 [/SUP], Cornelius J Clancy[SUP] 3 [/SUP], Jean-Pierre Gangneux[SUP] 4 [/SUP], Martin Hoenigl[SUP] 5 [/SUP], Katrien Lagrou[SUP] 6 [/SUP], Bart J A Rijnders[SUP] 7 [/SUP], Laura Seldeslachts[SUP] 8 [/SUP], Lore Vanderbeke[SUP] 9 [/SUP], Frank L van de Veerdonk[SUP] 10 [/SUP], Paul E Verweij[SUP] 11 [/SUP], Joost Wauters[SUP] 12 [/SUP]
Affiliations
- PMID: 39025089
- DOI: 10.1016/S2213-2600(24)00151-6
Influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) are increasingly recognised as important complications in patients requiring intensive care for severe viral pneumonia. The diagnosis can typically be made in 10-20% of patients with severe influenza or COVID-19, but only when appropriate diagnostic tools are used. Bronchoalveolar lavage sampling for culture, galactomannan testing, and PCR forms the cornerstone of diagnosis, whereas visual examination of the tracheobronchial tract during bronchoscopy is required to detect invasive Aspergillus tracheobronchitis. Azoles are the first-choice antifungal drugs, with liposomal amphotericin B as an alternative in settings where azole resistance is prevalent. Despite antifungal therapy, IAPA and CAPA are associated with poor outcomes, with fatality rates often exceeding 50%. In this Review, we discuss the mechanistic and clinical aspects of IAPA and CAPA. Moreover, we identify crucial knowledge gaps and formulate directions for future research.