Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China
Posted on 2020-07-08 - 04:26
Abstract Background The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria are widely used in the diagnosis of invasive pulmonary aspergillosis (IPA), but they only apply to immunocompromised patients. We here aimed to identify clinical characteristics helpful to the diagnosis of IPA in non-immunocompromised patients. Methods This is a multicenter retrospective study. Data were collected from adult patients with IPA admitted to 15 tertiary hospitals in China from 2010 to 2016. Results We included 254 patients in the study, of whom 66 (26.0%) were immunocompromised, and 188 (74.0%) were not. Airway-invasion-associated computed tomography (CT) signs including patchy exudation along the airway (67.6% vs. 45.5%, P = 0.001) and thickened airway wall (42.0% vs. 16.7%, P < 0.001) were more common in non-immunocompromised patients than in immunocompromised ones, and angio-invasive CT signs were more common in immunocompromised patients (55.3% vs.72.7%, P = 0.013). Typical angio-invasive CT signs were delayed in non-immunocompromised IPA patients, whereas airway-invasive signs appear earlier. Host immunocompromised condition was associated with ICU admission and/or intubation (OR 1.095; 95% CI 1.461–6.122; P = 0.003). Poor prognosis (35.5% vs. 21.1%, P = 0.005) was more common in immunocompromised patients. Conclusion Airway-invasion-associated CT presentations at early stages of the disease are characteristic of IPA in non-immunocompromised hosts.
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Liu, Zhibo; Li, Yuping; Tian, Xinlun; Liu, Qinghua; Li, Erran; Gu, Xiaoying; et al. (2020). Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.5052780.v1
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AUTHORS (19)
ZL
Zhibo Liu
YL
Yuping Li
XT
Xinlun Tian
QL
Qinghua Liu
EL
Erran Li
XG
Xiaoying Gu
ML
Min Liu
JX
Jiuyang Xu
ZH
Zhiyi He
YH
Yi Huang
SX
Shuyun Xu
GL
Guoxiang Lai
YC
Yusheng Chen
XZ
Xiangyan Zhang
TZ
Tiantuo Zhang
JX
Jinfu Xu
LZ
Lanyan Zhu
JQ
Jieming Qu
BC
Bin Cao