Morality Clinical Trial
Official title:
Clinical and Prognostic Comparisons Between Invasive Pulmonary Aspergillosis With or Without Invasive Tracheobronchitis During Severe Influenza: a Retrospective Multicenter Cohort Study.
Invasive tracheobronchial aspergillosis (ITBA) is an uncommon, but severe clinical form of Invasive Pulmonary Aspergillosis (IPA) in which the fungal infection is entirely or predominantly confined to the tracheobronchial tree. In view of the limited data concerning critically ill patients admitted to the intensive care unit (ICU) with severe influenza associated with ITBA, the investigators decided to evaluate the differences between the clinical presentations of two invasive infections: ITBA and IPA without tracheobronchial involvement (No ITBA).
Invasive pulmonary aspergillosis (IPA) is a well-known complication in severely
immunocompromised hosts patients. Recent evidence has identified others populations at risk
for IPA, including those with chronic obstructive pulmonary disease (COPD) and advanced
cirrhosis patients in intensive care units (ICUs). Moreover, Recently influenza has been
identified as a new independent risk factor for IPA and IPA was described as an early
complication of influenza. IPA groups different clinical presentations: the classical
angio-invasive, the broncho-invasive form and the invasive tracheobronchitis aspergillosis
form (ITBA).
ITBA is an infrequent clinical form of IPA with often a fatal outcome, in which Aspergillus
infection involves entirely or predominantly the tracheobronchial tree. Early diagnosis of
ITBA is based on bronchoscopy examination. Severe influenza is a life-threatening condition
where IPA has been repeatedly reported. Little is known on severe influenza infection
complicated with IPA and still less with ITBA. Current data on ITBA in critically ill
patients hospitalized for severe influenza infection has only been described in single case
reports. Because ITBA has been associated with a poorer prognostic than other forms of IPA,
this retrospective study aimed to analyze diagnostic and prognostic differences between ITBA
and IPA without tracheobronchial lesions, in critically ill patients with influenza infection
hospitalized in ICU.
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