2019
DOI: 10.1097/mcc.0000000000000637
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Diagnosing invasive pulmonary aspergillosis in ICU patients: putting the puzzle together

Abstract: Purpose of review The approach to diagnose invasive pulmonary aspergillosis in the absence of lung biopsy in ICU patients is reviewed. This approach should be based on four pillars: mycology, medical imaging, underlying conditions, and acute disease expression. Recent findings Diagnosing invasive pulmonary aspergillosis in the absence of histopathologic evidence is a matter of probability weighting. Initiating antifungal therapy in an early phase and wi… Show more

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Cited by 43 publications
(50 citation statements)
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“…; neutropenia, high dose glucocorticoid therapy), or demonstration of branching hyphae on BAL smear. [ 5 ] Accordingly, both patients in this report had putative CAPA.…”
Section: Discussionmentioning
confidence: 61%
See 3 more Smart Citations
“…; neutropenia, high dose glucocorticoid therapy), or demonstration of branching hyphae on BAL smear. [ 5 ] Accordingly, both patients in this report had putative CAPA.…”
Section: Discussionmentioning
confidence: 61%
“…[ [8] , [9] , [10] , 12 , 14 , 15 ] Lung biopsy is generally considered risky in ventilated patients, though this has occasionally been performed in patients with suspected CAPA. [ 5 , 10 ] Post-mortem histopathological confirmation of CAPA has also been reported. [ 16 ]…”
Section: Discussionmentioning
confidence: 99%
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“…IPA is known to be problematic to diagnose in the non-neutropenic ICU host [ 23 ]. Regardless of the compelling evidence for CAPA in this patient, the EORTC/MSGERC [ 24 ] host criteria for invasive fungal disease were not met, nor did the patient meet the AspICU algorithm because we tested tracheal aspirates instead of bronchoalveolar lavage (BAL) fluid [ 25 ].…”
Section: Discussionmentioning
confidence: 99%