LitCovid-sentences  

PMC:7306567 / 21368-26142 JSONTXT 13 Projects

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Id Subject Object Predicate Lexical cue
T142 0-52 Sentence denotes Criteria to define proven and probable cases of IAPA
T143 53-230 Sentence denotes The distinction between proven and probable IAPA is important for clinical trials, while in clinical practice, people should not distinguish between proven and probable disease.
T144 231-477 Sentence denotes 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).
T145 478-680 Sentence denotes 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.
T146 681-958 Sentence denotes 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).
T147 959-1016 Sentence denotes Table 1 Proposed case definition for IAPA in ICU patients
T148 1017-1117 Sentence denotes Entry criteria: influenza-like illness + positive influenza PCR or antigen + temporally relationship
T149 1118-1213 Sentence denotes Aspergillus tracheobronchitis IAPA in patients without documented Aspergillus tracheobronchitis
T150 1214-1500 Sentence denotes Proven 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
T151 1501-1548 Sentence denotes Probable Airway plaque, pseudomembrane or ulcer
T152 1549-1583 Sentence denotes and at least one of the following:
T153 1584-1604 Sentence denotes Serum GM index > 0.5
T154 1605-1607 Sentence denotes or
T155 1608-1626 Sentence denotes BAL GM index ≥ 1.0
T156 1627-1629 Sentence denotes or
T157 1630-1650 Sentence denotes Positive BAL culture
T158 1651-1653 Sentence denotes or
T159 1654-1688 Sentence denotes Positive tracheal aspirate culture
T160 1689-1691 Sentence denotes or
T161 1692-1715 Sentence denotes Positive sputum culture
T162 1716-1718 Sentence denotes or
T163 1719-1756 Sentence denotes Hyphae consistent with Aspergillus A:
T164 1757-1777 Sentence denotes Pulmonary infiltrate
T165 1778-1812 Sentence denotes and at least one of the following:
T166 1813-1833 Sentence denotes Serum GM index > 0.5
T167 1834-1836 Sentence denotes or
T168 1837-1855 Sentence denotes BAL GM index ≥ 1.0
T169 1856-1858 Sentence denotes or
T170 1859-1879 Sentence denotes Positive BAL culture
T171 1880-1882 Sentence denotes OR
T172 1883-1885 Sentence denotes B:
T173 1886-1941 Sentence denotes Cavitating infiltrate (not attributed to another cause)
T174 1942-1976 Sentence denotes and at least one of the following:
T175 1977-2000 Sentence denotes Positive sputum culture
T176 2001-2003 Sentence denotes or
T177 2004-2038 Sentence denotes Positive tracheal aspirate culture
T178 2039-2140 Sentence denotes A patient fulfilling the case definition of probable IAPA is required to fulfill the entry criterion.
T179 2141-2364 Sentence denotes A positive serum GM (GM index > 0.5) is important evidence for the diagnosis of IAPA, in patients with pulmonary infiltrates on chest X-ray or other imaging modality or bronchoscopic evidence of tracheobronchitis (Table 1).
T180 2365-2431 Sentence denotes In patients with tracheobronchitis, an infiltrate is not required.
T181 2432-2624 Sentence denotes In patients with endobronchial plaques or pulmonary infiltrates, a positive BAL GM or culture of a tracheal aspirate is considered mycological evidence that supports a probable IAPA diagnosis.
T182 2625-2780 Sentence denotes In patients with bacterial pneumonia where Aspergillus is cultured only from a sputum sample, there may be a risk of overdiagnosis and thus over-treatment.
T183 2781-2985 Sentence denotes For clinical practice, clinicians should take into account that a positive culture of an upper airway sample may indicate IAPA, but that confirmation with serum or BAL GM or BAL culture should be pursued.
T184 2986-3144 Sentence denotes However, one problem is that the background incidence varies in different regions, making it difficult to develop generalized guidelines that apply uniformly.
T185 3145-3251 Sentence denotes The significance of a positive sputum culture thus depends on the background incidence in a specific unit.
T186 3252-3471 Sentence denotes Although any Aspergillus-positive respiratory sample is in itself insufficient to classify patients as probable IAPA, a new pulmonary cavitating infiltrate is indicative of IAPA in patients who meet the entry criterion.
T187 3472-3665 Sentence denotes Therefore, any Aspergillus-positive respiratory sample is sufficient evidence to classify patients as probable IAPA provided that a pulmonary cavitating infiltrate is present (Table 1; Fig. 1).
T188 3666-3912 Sentence denotes Fig. 1 Flowchart of probable IAPA classification. (*)If hyphae consistent with Aspergillus are documented in a biopsy of an airway lesion AND Aspergillus is grown from sputum or a tracheal aspirate, the case fulfills the definition of proven IAPA
T189 3913-4126 Sentence denotes A BAL GM index cutoff of ≥ 1.0 is recommended as this cutoff value ensures high specificity, without decreasing sensitivity significantly, which is also in line with other definitions and recommendations [10, 57].
T190 4127-4288 Sentence denotes Aspergillus PCR is not recommended as a primary diagnostic tool because of concerns about its reliability and positive predictive value for the diagnosis of IPA.
T191 4289-4416 Sentence denotes However, Aspergillus PCR is recommended in the proven category because it enables Aspergillus identification in tissue samples.
T192 4417-4527 Sentence denotes In some patients, discordant results are obtained, for instance a positive sputum culture but negative BAL GM.
T193 4528-4774 Sentence denotes For most situations, IAPA classification relies on a positive GM test, as a positive sputum culture with a negative GM result would be interpreted as a lower probability of IAPA (unless a pulmonary cavity or tracheobronchitis is present)(Fig. 1).