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