How to manage aspergillosis in non-neutropenic intensive care unit patients

Matteo Bassetti, Elda Righi, Gennaro De Pascale, Raffaele De Gaudio, Antonino Giarratano, Tereesita Mazzei, Giulia Morace, Nicola Petrosillo, Stefania Stefani, Massimo Antonelli

Research output: Contribution to journalArticle

Abstract

Invasive aspergillosis has been mainly reported among immunocompromised patients during prolonged periods of neutropenia. Recently, however, non-neutropenic patients in the ICU population have shown an increasing risk profile for aspergillosis. Associations with chronic obstructive pulmonary disease and corticosteroid therapy have been frequently documented in this cohort. Difficulties in achieving a timely diagnosis of aspergillosis in non-neutropenic patients is related to the non-specificity of symptoms and to lower yields with microbiological tests compared to neutropenic patients. Since high mortality rates are typical of invasive aspergillosis in critically ill patients, a high level of suspicion and prompt initiation of adequate antifungal treatment are mandatory. Epidemiology, risk factors, diagnostic algorithms, and different approaches in antifungal therapy for invasive aspergillosis in non-neutropenic patients are reviewed.

Original languageEnglish
Article number458
JournalCritical Care
Volume18
Issue number4
DOIs
Publication statusPublished - Jul 25 2014

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

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    Bassetti, M., Righi, E., De Pascale, G., De Gaudio, R., Giarratano, A., Mazzei, T., Morace, G., Petrosillo, N., Stefani, S., & Antonelli, M. (2014). How to manage aspergillosis in non-neutropenic intensive care unit patients. Critical Care, 18(4), [458]. https://doi.org/10.1186/s13054-014-0458-4