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Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China

Zhibo Liu, Yuping Li, Xinlun Tian, Qinghua Liu, Erran Li, Xiaoying Gu, Min Liu, Jiuyang Xu, Zhiyi He, Yi Huang, Shuyun Xu, Guoxiang Lai (+7 others)
2020 Respiratory Research  

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https://web.archive.org/web/20200721220630/https://respiratory-research.biomedcentral.com/track/pdf/10.1186/s12931-020-01424-x

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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. This is a multicenter retrospective study. Data were collected from adult patients with IPA admitted to 15 tertiary hospitals in China from 2010 to
more » ... 6. 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. Airway-invasion-associated CT presentations at early stages of the disease are characteristic of IPA in non-immunocompromised hosts.
doi:10.1186/s12931-020-01424-x pmid:32635916 fatcat:5todk5elazdx3f3qj3j6ufzorm
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Zhibo Liu, Yuping Li, Xinlun Tian, Qinghua Liu, Erran Li, Xiaoying Gu, Min Liu, Jiuyang Xu, Zhiyi He, Yi Huang, Shuyun Xu, Guoxiang Lai, Yusheng Chen, Xiangyan Zhang, Tiantuo Zhang, Jinfu Xu, Lanyan Zhu, Jieming Qu, Bin Cao. "Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China." Respiratory Research 21.1 (2020) 173