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Invasive Pulmonary Aspergillosis in Nonimmunocompromised Hosts

Jean‐Jacques TudesqMédecine Intensive et Réanimation, Hôpital Saint-Louis, APHP et Université de Paris, ParisOlivier PeyronyMédecine Intensive et Réanimation, Hôpital Saint-Louis, APHP et Université de Paris, ParisVirginie LemialeMédecine Intensive et Réanimation, Hôpital Saint-Louis, APHP et Université de Paris, ParisÉlie AzoulayMédecine Intensive et Réanimation, Hôpital Saint-Louis, APHP et Université de Paris, Paris

2019en

ABI

Annotatsiya

Abstract Invasive pulmonary aspergillosis (IPA) is a fungal infection that is the hallmark of severe cellular or complex immune alterations. Evidence that IPA can occur in nonimmunocompromised hosts is increasing. Actually, up to 1% of general intensive care unit (ICU) patients present positive samples with Aspergillus spp. Both colonization and invasive disease are associated with poor outcome. Unexpected IPA has also been reported in approximately 1% of critically ill patients who underwent postmortem biopsies. In nonimmunocompromised patients with acute respiratory distress syndrome (ARDS), IPA prevalence can reach up to 15% of patients in both clinical and autopsy studies. Factors associated with IPA in nonimmunocompromised critically ill hosts include short and long courses of steroids, broad antibiotic therapy, chronic obstructive pulmonary disease, ARDS, liver failure, and the severity of organ dysfunctions. This review aims to appraise the prevalence of IPA in nonimmunocompromised hosts, address diagnostic challenges, and outcomes.

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DOI: 10.1055/s-0039-1696968

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