Division of General Internal Medicine, Department of Medicine, University of California San Diego, San Diego, CA, USA.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA.
Mycoses. 2021 Sep;64(9):1002-1014. doi: 10.1111/myc.13274. Epub 2021 Apr 6.
Invasive aspergillosis (IA) is an increasingly recognised phenomenon in critically ill patients in the intensive care unit, including in patients with severe influenza and severe coronavirus disease 2019 (COVID-19) infection. To date, there are no consensus criteria on how to define IA in the ICU population, although several criteria are used, including the AspICU criteria and new consensus criteria to categorise COVID-19-associated pulmonary aspergillosis (CAPA). In this review, we describe the epidemiology of IA in critically ill patients, most common definitions used to define IA in this population, and most common clinical specimens obtained for establishing a mycological diagnosis of IA in the critically ill. We also review the most common diagnostic tests used to diagnose IA in this population, and lastly discuss the most common clinical presentation and imaging findings of IA in the critically ill and discuss areas of further needed investigation.
侵袭性曲霉病（IA）是重症监护病房中重症患者日益被认识的一种现象，包括严重流感和严重 2019 冠状病毒病（COVID-19）感染的患者。迄今为止，尚无关于如何在 ICU 人群中定义 IA 的共识标准，尽管有几种标准在使用，包括 AspICU 标准和用于分类 COVID-19 相关肺曲霉病（CAPA）的新共识标准。在这篇综述中，我们描述了危重症患者中 IA 的流行病学，最常用于定义该人群中 IA 的常用定义，以及为建立危重症患者 IA 的真菌学诊断而获得的最常见临床标本。我们还回顾了最常用于诊断该人群中 IA 的诊断测试，最后讨论了危重症患者中 IA 的最常见临床表现和影像学发现，并讨论了进一步需要研究的领域。
