Diagnosis of Invasive Aspergillosis in Intensive Care Unit Patients

Abstract

Purpose of Review

Invasive aspergillosis is a frequent opportunistic infection in the intensive care unit. Diagnostic strategies within this setting are not well-defined.

Recent Findings

In the absence of histopathological proof, estimation of likelihood of disease is required, based on a combination of host factors with clinical, microbiological and radiologic findings. Importantly, the at-risk critically ill population has expanded beyond the classical immunosuppressed patients. Clinical features are non-specific, yet overt organ failure is associated with an increased risk and should raise the suspicion of invasive fungal disease. Validation of serological and molecular diagnostics is complicated by the lack of universal definitions in critically ill patients.

Summary

Improved awareness of novel risk groups can promote early diagnosis. Development of novel, host immune response driven biomarkers and universal definitions of invasive fungal disease in intensive care units is urgently needed.

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Correspondence to Katrien Lagrou.

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Lore Vanderbeke is a research fellow of the Research Foundation - Flanders (FWO Vlaanderen). Johan Maertens reports grants, personal fees and non-financial support from MSD; grants, personal fees and non-financial support from Gilead Sciences; grants, personal fees and non-financial support from Pfizer, Inc.; personal fees and non-financial support from Basilea; personal fees and non-financial support from Cidara; personal fees and non-financial support from F2G; grants from Immy; and grants from OLM outside the submitted work. Joost Wauters reports grants from MSD, other from Gillead, and grants from Pfizer outside the submitted work. Katrien Lagrou reports non-financial support from Pfizer, personal fees and non-financial support from MSD, personal fees from SMB Laboratoires, personal fees from Gilead, and personal fees from FUJIFILM Wako outside the submitted work. Eric Van Wijngaerden declares no conflicts of interest relevant to this manuscript.

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This article is part of the Topical Collection on Advances in Diagnosis of Invasive Fungal Infections

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Vanderbeke, L., Van Wijngaerden, E., Maertens, J. et al. Diagnosis of Invasive Aspergillosis in Intensive Care Unit Patients. Curr Fungal Infect Rep 14, 166–173 (2020). https://doi.org/10.1007/s12281-020-00383-6

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Keywords

  • Aspergillus
  • Invasive aspergillosis
  • Invasive fungal disease
  • Diagnosis
  • Intensive care
  • Critical illness