Sánchez Martín C, Madrid Martínez E, González Pellicer R, Armero Ibáñez R, Martínez González E, Llau Pitarch J V
Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitario Doctor Peset, Valencia, España.
Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitario Doctor Peset, Valencia, España.
Rev Esp Anestesiol Reanim (Engl Ed). 2021 Apr 20. doi: 10.1016/j.redar.2021.02.012.
Patients with COVID-19 who are admitted to intensive care unit (ICU) are at high risk of developing secondary infections, including invasive fungal infections such as invasive pulmonary aspergillosis (IPA). The main purpose was to analyse the putative COVID-19 Associated Pulmonary Aspergillosis (CAPA) patients in our setting. In these patients, we performed mycological culture in bronchoalveolar lavage (BAL) for isolation of Aspergillus sp. We followed the AspICU algorithm to diagnose putative IPA. Moreover, we considered relevant the positivity of galactomannan in BAL. We diagnosed putative IPA in 3 patients. The common features of these 3 patients were: more than 21 days of stay in ICU, severe acute respiratory distress syndrome (ARDS) and treatment with steroids (1mg/kg per day). Therefore, CAPA has to be systematically considered although a new algorithm to diagnose it is needed to treat patients in early stages in order to avoid catastrophic outcomes.
入住重症监护病房（ICU）的新冠肺炎患者发生继发感染的风险很高，包括侵袭性真菌感染，如侵袭性肺曲霉病（IPA）。主要目的是分析我们医院环境中疑似新型冠状病毒肺炎相关肺曲霉病（CAPA）的患者。对于这些患者，我们在支气管肺泡灌洗（BAL）中进行真菌培养以分离曲霉菌。我们遵循AspICU算法诊断疑似IPA。此外，我们认为BAL中半乳甘露聚糖阳性具有相关性。我们诊断出3例疑似IPA患者。这3例患者的共同特征是：在ICU住院超过21天、严重急性呼吸窘迫综合征（ARDS）以及接受类固醇治疗（每天1mg/kg）。因此，必须系统地考虑CAPA，尽管需要一种新的诊断算法来在早期阶段治疗患者，以避免灾难性后果。
