Clinical study of invasive pulmonary aspergillosis following influenza A H1N1

Abstract

This study to analyze the clinical characteristics of patients with invasive pulmonary aspergillosis (IPA) following influenza A (H1N1) infection.We retrospectively analyzed 10 cases with IPA following H1N1 infection. The clinical manifestations, laboratory examination results, chest computed tomography, and treatments were analyzed.Clinical manifestations: all 10 cases had typical flu-like symptoms at the onset of the disease, among which 7 patients developed dyspnea in the late stage, and 8 patients had hemoptysis. Laboratory examination: the absolute and percentage of peripheral blood lymphocytes in all 10 patients were declined, among which 5 cases were with decreased CD3+ CD4+ T cells/lymphocytes; 9 cases with increased bronchoalveolar lavage fluid galactomannan; 6 cases with increased serum galactomannan; 1 case with bronchoalveolar lavage fluid cultured aspergillus fumigatus; and 2 cases with aspergillus by second-generation sequencing. Chest computed tomography: all patients showed multiple diffused ground-glass opacities at the beginning, along with linear or reticular interstitial changes. Two cases had multiple subarachnoid nodules with halo signs, 3 cases had consolidation in multiple segments of both lungs, 2 cases had cavities, and 4 cases were with pleural effusion. Treatment: 10 patients were treated with antiviral and anti-Aspergillus drugs after admission. Four patients received respiratory support. All 10 cases were cured and discharged.Early diagnosis of IPA in influenza A (H1N1) patients is the key to successful treatment.

Medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen – Update 2023 (AWMF-Register-Nr. 161/001)

“…B. nach Tuberkulose [301,302]) sowie die Kombination dieser Faktoren, insbesondere bei der COPD [303,304], wurden mit einer erhöhten Schimmelpilzinfektionsrate assoziiert. Auch Patient*innen mit akutem Lungenversagen bei Influenza- [305][306][307][308][309][310] oder COVID-19-Erkrankung [305,[311][312][313][314][315][316][317][318] können eine invasive Schimmelpilzinfektion erleiden.…”

“…Auch Patient*innen mit Influenza [305][306][307][308][309][310] und Patient*innen mit COVID-19 [305,[311][312][313][314][315][316][317][318] haben ein erhöhtes Risiko, an Pilzinfektionen zu erkranken.…”

AWMF mold guideline “Medical clinical diagnostics for indoor mold exposure” – Update 2023 AWMF Register No. 161/001

“…However, other immunosuppressions, such as prolonged corticosteroid use and pulmonary scaffolding diseases (including scarred residual conditions, e.g., after tuberculosis [ 18 , 663 ]) and the combination of these factors, particularly in COPD [ 238 , 249 ], have been linked to increased rates of mold infections. Patients with acute respiratory failure due to influenza [ 8 , 114 , 281 , 406 , 427 , 648 ] or COVID-19 [ 8 , 37 , 174 , 541 , 588 , 613 , 615 , 733 , 749 ] can suffer an invasive mold infection.…”

“…Patients with influenza [ 8 , 114 , 281 , 406 , 427 , 648 ] and patients with COVID-19 [ 8 , 37 , 174 , 541 , 588 , 613 , 615 , 733 , 749 ] have an increased risk of contracting fungal infections.…”

Statement des Netzwerkes Schimmelpilzberatung Deutschland zu gesundheitlichen Risiken durch Schimmel im Innenraum in Zusammenhang mit Armutsgefährdung

“…Personen mit Abwehrschwäche 16 18 19 20 21 22 23 , schwerer Influenza- und/oder SARS-CoV-2-Infektion 23 24 25 26 27 28 29 30 31 , Mukoviszidose 16 sind besonders bzgl. Feuchte-/Schimmelschäden zu schützen.…”