Diagnosing invasive pulmonary aspergillosis in ICU patients: putting the puzzle together

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 with a lower likelihood of disease might outweigh further diagnostic workout with further delay in appropriate treatment. However, in ICU patients, a preemptive antifungal strategy has not been established yet. Summary For mycology, a positive galactomannan test on serum or broncho-alveolar lavage fluid is highly indicative of invasive pulmonary aspergillosis. The meaning of positive culture results, lateral-flow device test, or PCR-assay is ambiguous. A negative galactomannan or PCR test has high negative predictive value. Clinical features suggestive for invasive fungal disease on CT-scan are highly indicative but rare in ventilated patients. An immunocompromised status indicates high-risk. chronic obstructive pulmonary disease, hepatic cirrhosis, and AIDS indicate moderate risk. Invasive pulmonary aspergillosis in the absence of underlying conditions is rare. Acute diseases frequently associated with invasive pulmonary aspergillosis include sepsis and/or respiratory insufficiency because of influenza, acute respiratory...
Source: Current Opinion in Critical Care - Category: Nursing Tags: SEVERE INFECTIONS: Edited by Michael S. Niederman Source Type: research

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Source: Food Chemistry - Category: Food Science Source Type: research
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Source: Artificial Intelligence in Medicine - Category: Bioinformatics Source Type: research
CONCLUSIONS: Increased IP is found in 23% of cirrhotic patients. Permeability alterations are significantly more pronounced in patients with advanced LC with the presence of ascites and in those with alcoholic etiology. PMID: 31957845 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
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Source: Physics of the Earth and Planetary Interiors - Category: Physics Source Type: research
Authors: Hosoda C, Ishiguro T, Morimoto Y, Furube A, Isono T, Shimizu Y, Takayanagi N Abstract We herein report a 62-year-old man with idiopathic pulmonary fibrosis who developed remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome during follow-up. Pulmonary infiltrations were detected concomitantly with the development of RS3PE syndrome, and prednisolone improved both the pulmonary and extrapulmonary lesions. Recognizing the pulmonary manifestations of RS3PE syndrome is necessary to provide an appropriate diagnosis and disease management. PMID: 31956200 [PubMed - as supplied by publisher]
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Source: Molecular and Cellular Probes - Category: Molecular Biology Source Type: research
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Source: Methods - Category: Molecular Biology Source Type: research
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Source: Micron - Category: Biology Source Type: research
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Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Respir Med Case Rep Source Type: research
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Source: Thermochimica Acta - Category: Chemistry Source Type: research
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