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[Invasive aspergillosis in intensive care]
P Le Conte1, Y Blanloeil, P Germaud
1Service des Urgences, CHU, Nantes.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1995
Summary
Invasive pulmonary aspergillosis is a serious pneumonia in immunocompromised patients, diagnosed via bronchoalveolar lavage. Early diagnosis and treatment with amphotericin B are crucial for survival.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Context:
- Invasive pulmonary aspergillosis affects immunocompromised individuals, including those undergoing chemotherapy, organ transplant recipients, and surgical patients.
- Clinical presentation mimics pneumonia unresponsive to antibiotics, with often non-specific radiographic findings.
Purpose:
- To outline the clinical characteristics, diagnostic methods, and treatment strategies for invasive pulmonary aspergillosis.
Summary:
- Diagnosis relies on bronchoalveolar lavage identifying Aspergillus, as serological tests have limited utility.
- Extrapulmonary involvement occurs in 20% of cases, affecting sites like sinuses, skin, and brain.
- Intravenous amphotericin B is the primary treatment, with potential for oral itraconazole as a follow-up; managing nephrotoxicity is key.
Impact:
- Highlights the high mortality associated with invasive aspergillosis.
- Emphasizes the critical need for prompt diagnosis and effective treatment to improve patient outcomes.