Table 2. Immediate cause of death for patients with IA.
| Cause of death 1 | IA-related death N = 62 (%) | IA-unrelated death N = 30 (%) | Total N = 92 (%) | p 2 | |
|---|---|---|---|---|---|
| Respiratory failure | 50 (80.6) | 9 (30) | 59 (64.1) | <.001 | |
| - caused primarily by Aspergillus infection | 24 (38.7) | 0 | 24 (26.1) | <.001 | |
| - caused by Aspergillus infection and concomitant lung infections 3 | 14 (22.6) | 6 (20) | 20 (21.7) | .99 | |
| - caused by Aspergillus infection and severe comorbidities 4 | 12 (19.4) | 3 (10) | 15 (16.3) | .37 | |
| Underlying disease 5 | 6 (9.7) | 12 (40) | 18 (19.6) | <.01 | |
| Septic shock caused by bloodstream infection 6 | 5 (8.1) | 11 (36.7) | 14 (15.2) | <.01 | |
| Pulmonary hemorrhage 7 | 10 (16.1) | 0 | 10 (10.9) | .03 | |
| Neurological conditions 8 | 7 (11.3) | 1 (3.3) | 8 (8.7) | .27 | |
| Multiorganic failure 9 | 7 (11.3) | 0 | 7 (7.6) | .09 | |
| Other 10 | 2 (3.2) | 12 (40) | 14 (15.2) | <.001 |
1 More than >1 cause of death was considered in 38 patients.
2 Differences between IA-related and IA-related mortality.
3 Cytomegalovirus, 7 patients; Pseudomonas aeruginosa, 5 patients; Pneumocystis jirovecii, 3 patients; Influenza A(H1N1)pdm09, 3 patients; Streptococcus pneumoniae, 2 patients; nocardiosis, 2 patients; Rhodococcus equi, 1 patient; respiratory syncytial virus, 1 patient; aspiration pneumonia, 1 patient. Three respiratory co-pathogens were found in 5 patients.
4 Severe chronic obstructive pulmonary disease, 8 patients; GVHD, 3 patients; and in 1 patient each: cerebrovascular disease, lung cancer, pulmonary fibrosis, and acute pulmonary thromboembolism.
5 Acute myeloid leukemia relapse, 6 patients; graft failure in organ solid recipients, 4 patients (two lung, one kidney, one liver); GVHD, 4 patients with allo-hematopoietic stem cell transplantation; cavum massive hemorrhage secondary to solid cancer, 1 patient; advanced lung cancer, 1 patient; intestinal obstruction in patient with metastatic cancer, 1 patient; severe aplasia after chemotherapy in one patient with chronic lymphocytic leukemia.
6 Gram-negative bacilli, 6 patients; Enterococcus spp., 4 patients; Listeria monocytogenes, 1 patient; Streptococcus pneumoniae, 1 patient; Candida albicans, 1 patient; polymicrobial bacteremia with Enterococcus faecim and Achromobacter dentrificans, 1 patient.
7 Necrotizing pneumonia caused by Aspergillus in patients with severe pancytopenia due to hematologic disease, 5 patients (in one case co-infection with Pseudomonas aeruginosa was found); necrotizing pneumonia caused by Aspergillus in patients with pancytopenia and/or coagulopathy due to liver disease, 3 patients; necrotizing pneumonia caused by Aspergillus, 1 case; necrotizing pneumonia caused by Aspergillus and Pseudomonas aeruginosa, 1 case.
8 Brain herniation caused by focal lesion +/- cerebral hemorrhage caused by Aspergillus in central nervous system, 5 patients; cerebral ischemic event, 2 patients; primary brain hemorrhage, 1 patient.
9 Disseminated invasive aspergillosis with multiorganic failure, 3 cases; multiorganic failure caused by respiratory failure due to Aspergillus and liver failure due to severe underlying liver disease, 3 patients; multiorganic failure caused by respiratory failure due to Aspergillus and heart failure after cardiac transplantation, 1 patient.
10 Clostridium difficile infection, 4 patients (co-infection with CMV was found in 1 case); sudden cardiopulmonary arrest in patients with multifactorial encephalopathy, 2 patients; sudden cardiac arrest, 2 patients; acute myocardial ischemia, 1 patient; neutropenic colitis, 1 patient, intestinal ischemia and secondary peritonitis, 1 case; post-surgical esophageal perforation and secondary mediastinitis, 1 case; severe cachexia (adult/32 kg), 1 case; diabetic ketoacidosis, 1 case.