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Rev Mal Respir. 2018 Feb;35(2):171-187. doi: 10.1016/j.rmr.2018.01.002. Epub 2018 Feb 23.

[Invasive pulmonary aspergillosis].

[Article in French]

Author information

1
Service des maladies respiratoires, CHU de Bordeaux, 33604 Bordeaux, France. Electronic address: elodie.blanchard@chu-bordeaux.fr.
2
Service de parasitologie et de mycologie, CHU de Bordeaux, 33604 Bordeaux, France.
3
Service d'hygiène hospitalière, CHU de Bordeaux, 33604 Bordeaux, France.
4
Service de pharmacie à usage intérieur, groupe hospitalier Sud, CHU de Bordeaux, 33604 Bordeaux, France.
5
Service d'hématologie clinique et de thérapie cellulaire, CHU de Bordeaux, 33604 Bordeaux, France.

Abstract

INTRODUCTION:

Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in a wide range of patients. Early recognition and diagnosis have become a major focus in improving the management and outcomes of this life-threatening disease.

BACKGROUND:

IPA typically occurs during a period of severe and prolonged neutropenia. However, solid organ transplant recipients, patients under immunosuppressive therapy or hospitalized in intensive care units are also at risk. The diagnosis is suspected in the presence of a combination of clinical, biological and CT scan evidence. The microbiological diagnostic strategy should be adapted to the patient's profile. Conventional methods with culture and species identification remain the standard but early diagnosis has been improved by the use of biomarkers such as galactomannan antigen in serum or in bronchoalveolar lavage.

OUTLOOK:

The epidemiology of IPA should change with the increased use of antifungal prophylactic regimens and the arrival of targeted therapies. Other microbiological tools, such as PCR and other biomarkers, are currently being assessed.

CONCLUSIONS:

IPA must be considered in a wide range of patients. Its prognosis remains poor despite progress in the microbiological diagnosis and therapeutic management.

KEYWORDS:

Antigène galactomannane; Aspergillose invasive; Aspergillus; Galactomannan; Immunocompromised host; Immunodéprimé; Invasive aspergillosis; Neutropenia; Neutropénie

PMID:
29478757
DOI:
10.1016/j.rmr.2018.01.002
[Indexed for MEDLINE]

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