Influenza Associated Pulmonary Aspergillosis: A Retrospective Study from a Tertiary Care Center in Lebanon
DOI:
https://doi.org/10.26738/poem.v2i1.28Abstract
Introduction
Influenza-associated pulmonary aspergillosis (IAPA) has been reported in multiple cohort studies, typically in the immunocompromised host. Limited data is available from the Middle Eastern region.
Methods
This is a retrospective study conducted at the American University of Beirut Medical Center (AUBMC) between January 1 2014 and March 1 2019, to describe the clinical characteristics, risk factors and outcomes of patients with influenza and invasive pulmonary aspergillosis (IPA). Six hundred fifty six patients were admitted with influenza pneumonia. Data about positive cultures for Aspergillus sp. isolated from sputum, deep tracheal aspirates (DTA) or bronchoalveolar lavage (BAL) or a positive aspergillus galactomannan test (GM) in serum or BAL was collected. Cases were identified based on the definitions and criteria for influenza and invasive aspergillosis suggested by the European Organization for Research and Treatment of Cancer/Mycoses study Group (EORTC/MSG), EORTC/MSG intensive care unit (EORTC/MSGERC ICU) Working Group, and IAPA definition.
Results
Nine patients had a positive result for Aspergillus sp. in culture or GM. Based on the EORTC/MSG criteria, 7 patients were classified as probable cases of IPA, and one as a possible case. On the other hand, only 2 patients were classified as probable cases of invasive fungal infection (IFI) based on the IAPA criteria. Only 1 out of 9 patients died. There was a preponderance of aspergillosis among immunocompromised patients.
Conclusion
Our study showed that the incidence of IPA in influenza patients was low compared to the data reported from European countries. This calls for national and regional surveillance to better understand the epidemiological variation in the regions.
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Copyright (c) 2024 Fatima Allaw, Rozana El Eid, Michel Almardini, Nabih Habib, Imad Bou Akl, Aline El Zakhem, Souha S. Kanj
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