Table 1. Diagnostic criteria and results for 164 patients with previous IFD.
Diagnostic criteria | IFD category | Total (%) n = 164 | |||
Proven (%) | Probable (%) | ||||
IPA | IC | IPA | IC | ||
n = 10 | n = 6 | n = 113 | n = 35 | ||
Host factors | |||||
Neutropenia (>10 days) | 10 (100) | 6 (100) | 45 (39.8) | 17 (48.6) | 78 (47.6) |
T>38°C with prolonged neutropenia | 10 (100) | 6 (100) | 45 (39.8) | 12 (34.3) | 73 (44.5) |
Immunosuppressant | 5 (50) | 4 (66.7) | 57 (50.4) | 25 (71.4) | 91 (55.5) |
Previous IFD | 10 (100) | 6 (100) | 113 (100) | 35 (100) | 164 (100) |
With AIDS | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
GVHD | 3 (30) | 2 (33.3) | 22 (19.5) | 7 (20) | 34 (20.7) |
Corticosteroids# | 6 (60) | 2 (33.3) | 46 (40.7) | 15 (42.9) | 69 (42.1) |
Clinical criteria | |||||
Halo sign | 8 (80) | 6 (100) | 80 (70.8) | 29 (82.9) | 123 (75) |
Air-crescent sign | 5 (50) | 1 (16.7) | 15 (13.3) | 7 (20) | 28 (17.1) |
Cavity | 3 (30) | 0 (0) | 11 (9.7) | 5 (14.3) | 19 (11.6) |
Symptoms of LRI | 7 (70) | 6 (100) | 60 (53.1) | 23 (65.7) | 96 (58.5) |
Permanent fever | 5 (50) | 4 (66.7) | 64 (56.6) | 25 (71.4) | 98 (59.8) |
Mycological criteria | |||||
Positive sputum microscopy | 0 (0) | / | 42 (37.2) | / | 42 (25.6) |
Positive sputum culture | 2 (20) | / | 36 (31.9) | / | 38 (23.2) |
G test positive | 3 (30) | 1 (16.7) | 22 (19.5) | 11 (31.4) | 37 (22.6) |
qPCR [31] * | 4 (100) | / | 16 (88.9) | / | 20 (90.9) |
Positive blood culture | 0 (0) | 6 (100) | 0 (0) | 0 (0) | 6 (3.7) |
No bacterial positive | 0 (0) | 0 (0) | 32 (28.3) | 16 (45.7) | 48 (29.3) |
Histology | |||||
Biopsy specimen of the lung | 10 (100) | 3 (50) | 0 (0) | 0 (0) | 13 (7.9) |
IFD, invasive fungal diseases; IPA, invasive pulmonary Aspergillosis; IC, invasive Candida; AIDS, acquired immune deficiency syndrome; GVHD, graft versus host disease; LRI, lower respiratory infections; qPCR, real-time qualitative polymerase chain reaction.
Corticosteroid was defined as 1 mg/kg or 2 mg/kg for more than 3 weeks for the treatment of acute lymphoblastic leukemia or for the management of GVHD before IFD.
*4 proven IPA patients and 18 probable IPA patients were included in a qPCR diagnostic for IPA study, while 4 (4/4, 100%) and 16 (16/18, 88.9%) were qPCR positive respectively.