Why are so many cases of invasive aspergillosis missed?

Medical Mycology
François DanionOlivier Lortholary

Abstract

Invasive aspergillosis (IA) incidence is increasing in several countries like France, and numerous cases are indeed missed and still only diagnosed at autopsy as evidenced by recently published data. Such missed diagnoses are obviously encountered when appropriate diagnostic tools are not available especially in low resource areas or when biologists have not been trained enough in medical mycology (i.e., microscopic examination and culture in most of those areas). Besides logistical issues, which are indeed critical, IA may not be recognized because clinicians failed to consider that risk factors are evolving with the IA burden now observed among patients with chronic lymphoid malignancies or receiving new biotherapies, with diabetes mellitus or liver cirrhosis and/or acute alcoholic hepatitis, with patients from the intensive care unit (ICU) and among patients with some predisposing primary immune deficiencies now reaching the adult's age. This is also the case for human immunodeficiency virus (HIV)-infected patients who failed to meet the classical definitions of IA. From the radiology perspective, new entities of IA have also emerged which absolutely need to be recognized especially bronchial-based-IA among allogeneic stem c...Continue Reading

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Citations

Jul 31, 2019·Current Opinion in Critical Care·Stijn BlotDespoina Koulenti
Jul 2, 2020·American Journal of Respiratory and Critical Care Medicine·Laura LoughlinRonan McMullan
Dec 6, 2020·Journal of Tropical Pediatrics·Buyun ShiHui Xu
Feb 19, 2021·Scientific Reports·Kátia Cristina DantasPaulo Hilário Nascimento Saldiva

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