Table 2.
Mycological Characteristics of 21 Patients Critically Ill with Viral Pneumonia in the Autopsy Cohort with Probable Antemortem Invasive Pulmonary Aspergillosis Diagnosis
| Autopsy Cohort Patients with Antemortem Probable IPA Diagnosis (n = 21) | |
|---|---|
| Timing of antemortem IPA diagnosis | |
| Time between ICU admission and IPA diagnosis, d | 6 (3–17) |
| Time between viral symptom onset and IPA diagnosis, d | 14 (10–21) (n = 19) |
| Serum GM test positive (ODI > 0.5) | 5 (24) |
| Time between first positive GM serum and ICU admission, d | 9 (4–17) (n = 5) |
| Median ODI if positive | 4.6 (2.9–5.1) (n = 5) |
| BAL GM test positive (ODI ⩾ 1.0) | 20 (95) |
| Time between first positive GM BAL and ICU admission, d | 6 (2–21) (n = 20) |
| Median ODI if positive | 5.5 (4.6–6.1) (n = 20) |
| Fungal culture positive | |
| Positive fungal bronchial aspirate culture | 10 (48) |
| Positive fungal BAL fluid culture | 9 (43) |
| Tracheobronchitis* macroscopic diagnosis | 6 (29) |
| CT thorax cavitation | 2 (10) |
| Antifungal therapy | |
| Mold-active antifungal therapy during ICU | 21 (100) |
| Duration of treatment, d | 9 (6–25) |
| Tissue diagnosis of aspergillosis | |
| Histological evidence of IPA (all forms) | 11 (52) |
| Proven invasive Aspergillus tracheobronchitis | 4 (19) |
| Proven invasive pulmonary aspergillosis | 10 (48) |
Definition of abbreviations: CT = computed tomography; GM = galactomannan; IPA = invasive pulmonary aspergillosis; ODI = optical density index.
Data are number (percentage) or median (interquartile range).
*
Tracheobronchitis: signs of Aspergillus tracheobronchitis upon bronchoscopic evaluation include ulceration(s), nodule(s), pseudomembrane(s), plaque(s), and eschar(s).