PMC:7306567 / 21599-23406 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7306567","sourcedb":"PMC","sourceid":"7306567","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7306567","text":"The criteria for proven disease include a patient fulfilling the entry criterion plus histological evidence of invasive fungal elements and mycological evidence for the presence of Aspergillus (obtained by Aspergillus PCR or culture from tissue). Tracheobronchitis (tracheal and/or bronchial ulcerations or nodules, pseudomembranes or plaques visualized at bronchoscopy), as also described in the EORTC/MSGERC definitions [10], is a separate entity. Although a tissue biopsy would normally be required to prove a case of IAPA, in tracheobronchitis cases hyphal elements suggestive of Aspergillus seen on sloughed-off pseudomembrane, and Aspergillus identified on culture or PCR, can also be considered proven disease (Table 1).\nTable 1 Proposed case definition for IAPA in ICU patients\nEntry criteria: influenza-like illness + positive influenza PCR or antigen + temporally relationship\nAspergillus tracheobronchitis IAPA in patients without documented Aspergillus tracheobronchitis\nProven Biopsy or brush specimen of airway plaque, pseudomembrane or ulcer showing hyphal elements and Aspergillus growth on culture or positive Aspergillus PCR in tissue Lung biopsy showing invasive fungal elements and Aspergillus growth on culture or positive Aspergillus PCR in tissue\nProbable Airway plaque, pseudomembrane or ulcer\nand at least one of the following:\nSerum GM index \u003e 0.5\nor\nBAL GM index ≥ 1.0\nor\nPositive BAL culture\nor\nPositive tracheal aspirate culture\nor\nPositive sputum culture\nor\nHyphae consistent with Aspergillus A: Pulmonary infiltrate\nand at least one of the following:\nSerum GM index \u003e 0.5\nor\nBAL GM index ≥ 1.0\nor\nPositive BAL culture\nOR\nB: Cavitating infiltrate (not attributed to another cause)\nand at least one of the following:\nPositive sputum culture\nor\nPositive tracheal aspirate 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