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Table 2 Clinical, radiologic and microbiologic findings related to Aspergillus diagnosis

From: Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes

  All patients ( N= 563) Proven IA ( n= 94) Putative IA ( n= 203) Colonization ( n= 266)
ICU stay before first positive culture, days 4 (1 to 9) 4 (1 to 11) 4 (2 to 10) 4 (2 to 9)
SOFA II score at diagnosis 8 (4 to 12) 11 (7 to 14)b,c 9 (6 to 12)b 5 (3 to 10)
Clinical signs, n (%)   
 At least one of the following signs 317 (56) 73 (77)b 141 (69)b 103 (39)
  Refractory fever 163 (29) 53 (57)b,c 68 (34)b 42 (16)
  Recrudescent fever 18 (3) 4 (3) 7 (3) 7 (3)
  Pleuritic chest pain 18 (3) 5 (5) 8 (4) 5 (2)
  Pleuritic rub 6 (1) 3 (3) 0 3 (1)
  Dyspnea 257 (46) 45 (48)b,c 129 (64) 83 (31)
  Hemoptysis 32 (6) 14 (15)b,c 13 (6) 5 (2)
  Worsening lung function 219 (39) 61 (66)b 118 (58)b 40 (15)
Abnormal radiologic findings 487 (87) 94 (100)b 203 (100)b 191 (71)
 Chest X-ray/CT scan, n (%) 515 (91)/223 (40) 86 (92)/62 (67)b,c 192 (95)/96 (47)b 237 (89)/65 (24)
 Non-specific chest CT scan findings, n 135/223 33/62b 55/96b 57/65
 “Typical” chest CT scan findings, n 84/223 29/62b 41/96b 4/65
Microbiologic findings   
 BALa/ETA, n (%) 477 (96) 79 (92) 182 (98) 216 (97)
 BALa performed, n (%) 225 (40) 56 (60)b 112 (55)b 57 (21)
 Positive GM culture, n/mes (%) 86/151 (57) 44/52 (84)b 31/37 (84)b 11/62 (18)
 β-d-glucan, n/mes (%) 3/6 (50) 0 3/5 (60) 0/1 (0)
 PCR, n/mes (%) 4/4 (100) 0 3/3 (100) 1/1 (100)
 Performed biopsy/autopsy, n (%) 72/61 (24) 93 (100)b,c 15 (7) 25 (9)
Isolated species, n (%)   
Aspergillus fumigatus 519 (92) 83 (88) 182 (90) 254 (96)
Aspergillus flavus 19 (3) 2 (2) 12 (6) 5 (2)
Aspergillus niger 7 (1) 2 (2) 2 (1) 3 (1)
 Others 18 (3) 7 (8) 7 (3) 4 (2)
EORTC host factors, n (%)   
 EORTC host factor present on diagnosis 249 (44) 65 (70)b 143 (70)b 41 (15)
 Neutropenia 34 (6) 8 (9)b 21 (10)b 5 (2)
 Malignancy under cytotoxic therapy 66 (12) 18 (19)b 37 (18)b 11 (4)
 Glucocorticoid treatment 256 (45) 59 (63)b,c 156 (78)b 42 (15)
 Inherited severe immunodeficiency 11 (2) 3 (3) 6 (3) 0
Organ support at time of diagnosis, n (%)   
 Vasopressor therapy 346 (61) 63 (67)b 138 (68)b 145 (55)
 RRT 155 (28) 48 (51)b,c 61 (30)b 46 (18)
 Mechanical ventilation 482 (86) 92 (98)b,c 177 (87) 214 (80)
Organ support during ICU stay, n (%)   
 Vasopressor therapy 429 (76) 78 (83)b 168 (83)b 183 (69)
 RRT 182 (32) 57 (60)b,c 71 (35)b 54 (21)
 Mechanical ventilation 506 (90) 86 (91) 187 (92) 233 (87)
  1. aBAL, Bronchoalveolar lavage; CT, Computed tomography; EORTC, European Organization for Research and Treatment of Cancer; ETA, Endotracheal aspirate; GM, Galactomannan; IA, Invasive aspergillosis; ICU, Intensive care unit; RRT, Renal replacement therapy; SOFA, Sepsis Organ Failure Assessment. b P < 0.05 versus colonization; c P < 0.05 versus putative.