Influenza associated pulmonary aspergillosis in california: A case series

John Z. Deng; Karlyn D. Beer; Mitsuru Toda; Brendan Jackson; Tiffany Lin; Marjan Javanbakht; Chrysovalantis Stafylis; Tom Chiller; Jeffrey D. Klausner

Clinical Infection in Practice (Jan 2022)

Influenza associated pulmonary aspergillosis in california: A case series

John Z. Deng,
Karlyn D. Beer,
Mitsuru Toda,
Brendan Jackson,
Tiffany Lin,
Marjan Javanbakht,
Chrysovalantis Stafylis,
Tom Chiller,
Jeffrey D. Klausner

Affiliations

John Z. Deng: Department of Infectious Disease, University of California at Los Angeles, Los Angeles, CA, USA; Corresponding author at: 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
Karlyn D. Beer: Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
Mitsuru Toda: Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
Brendan Jackson: Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
Tiffany Lin: Department of Pathology, University of California at Los Angeles, Los Angeles, CA, USA
Marjan Javanbakht: Department of Infectious Disease, University of California at Los Angeles, Los Angeles, CA, USA
Chrysovalantis Stafylis: Department of Infectious Disease, University of California at Los Angeles, Los Angeles, CA, USA
Tom Chiller: Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
Jeffrey D. Klausner: Department of Population and Public Health Sciences of the Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Journal volume & issue: Vol. 13
p. 100123

Abstract

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Introduction: Invasive pulmonary aspergillosis has been reported to occur in patients who are critically ill with severe influenza. The mortality rate is high. Methods: We reviewed electronic medical records from University of California at Los Angeles Health Hospitals for patients who had a positive influenza and Aspergillus test from September 1st, 2019 to May 6th, 2020. We classified cases using definitions from the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG), Aspergillus Intensive Care Unit (AspICU), and Influenza Associated Pulmonary Aspergillosis (IAPA) definition. Results: We identified 8 cases where the patient had both a positive influenza and Aspergillus test. Four (50%) of the 8 patients did not have underlying conditions that were considered typical risk factors for aspergillosis. Seven (87.5%) of the 8 patients were admitted to the intensive care unit and four (50%) of the 8 patients died. One patient met the diagnostic criteria by the EORTC/MSG guidelines, six by the AspICU, and seven by the IAPA definition. Conclusion: We found cases of influenza-associated pulmonary aspergillosis in a Los Angeles hospital population. Typical underlying conditions for aspergillosis were absent in four of the 8 cases. The ability to categorize the cases as influenza associated pulmonary aspergillosis varied. Further research and development of more sensitive guidelines to establish a diagnosis of invasive pulmonary aspergillosis in patients critically ill with influenza may be warranted.

Published in Clinical Infection in Practice

ISSN: 2590-1702 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Infectious and parasitic diseases
Website: https://www.journals.elsevier.com/clinical-infection-in-practice/

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