Why are so many cases of invasive aspergillosis missed?
| Autor: | Claire Rouzaud, Marie-Elisabeth Bougnoux, Alexandre Alanio, Sylvain Poirée, Olivier Lortholary, Amélie Duréault, François Danion, Fanny Lanternier |
|---|---|
| Přispěvatelé: | Centre d'infectiologie Necker-Pasteur [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Aspergillus, Institut Pasteur [Paris], Université Paris Descartes - Paris 5 (UPD5), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), CHU Saint Louis [APHP], F.D. reports speaker fees from Gilead outside the submitted work. M.E.B. has received institutional grant funding from MSD and Astellas and lecture fees or travel grants from MSD, Pfizer, Astellas, and Gilead Sciences. A.A. has received travel grant from MSD, Gilead and Astella and honoraria from Pathoquest and Gilead outside the submitted work. F.L. reports speaker fees from MSD, Gilead and Basilea. O.L. has been a consultant for Gilead Sciences, a member of the speakers’ bureau for Pfeizer, Novartis, Astellas, Merck, and Gilead Sciences, and has received research grants from Gilead Sciences. C.R., A.D., and S.P.: no conflicts to declare, Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris] (IP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Hopital Saint-Louis [AP-HP] (AP-HP), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris] |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
MESH: Invasive Pulmonary Aspergillosis Cirrhosis diagnosis Autopsy Aspergillosis law.invention 03 medical and health sciences Immunocompromised Host law MESH: Risk Factors Risk Factors Diabetes mellitus MESH: Immunocompromised Host Medicine Humans aspergillosis MESH: Incidence Medical diagnosis airway-invasive Intensive care medicine MESH: Diagnostic Tests Routine [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology 030304 developmental biology Invasive Pulmonary Aspergillosis 0303 health sciences MESH: Humans 030306 microbiology business.industry Diagnostic Tests Routine Incidence (epidemiology) Incidence General Medicine medicine.disease Intensive care unit 3. Good health MESH: France Infectious Diseases PCR galactomannan France business Acute Alcoholic Hepatitis |
| Zdroj: | Medical Mycology Medical Mycology, Oxford University Press, 2019, 57 (Supplement_2), pp.S94-S103. ⟨10.1093/mmy/myy081⟩ Medical Mycology, 2019, 57 (Supplement_2), pp.S94-S103. ⟨10.1093/mmy/myy081⟩ |
| ISSN: | 1460-2709 1369-3786 1365-280X |
| Popis: | International audience; Invasive aspergillosis (IA) incidence is increasing in several countries like France, and numerous cases are indeed missed and still only diagnosed at autopsy as evidenced by recently published data. Such missed diagnoses are obviously encountered when appropriate diagnostic tools are not available especially in low resource areas or when biologists have not been trained enough in medical mycology (i.e., microscopic examination and culture in most of those areas). Besides logistical issues, which are indeed critical, IA may not be recognized because clinicians failed to consider that risk factors are evolving with the IA burden now observed among patients with chronic lymphoid malignancies or receiving new bio-therapies, with diabetes mellitus or liver cirrhosis and/or acute alcoholic hepatitis, with patients from the intensive care unit (ICU) and among patients with some predisposing primary immune deficiencies now reaching the adult's age. This is also the case for human immunodeficiency virus (HIV)-infected patients who failed to meet the classical definitions of IA. From the radiology perspective, new entities of IA have also emerged which absolutely need to be recognized especially bronchial-based-IA among allogeneic stem cell transplant recipients. Finally, from the laboratory side, contribution and limits of indirect blood biomark-ers should be integrated to the clinical life in order not to miss IA cases. To conclude, several diagnostic tools should be combined and a constant dialog between laboratory and clinics is crucial to appropriately diagnose IA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|