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Invasive Aspergillosis Associated With Severe Influenza Infections

tetano

Editor, Senior Moderator
Open Forum Infect Dis. 2016 Aug 10;3(3):ofw171. eCollection 2016.
[h=1]Invasive Aspergillosis Associated With Severe Influenza Infections.[/h] Crum-Cianflone NF[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] Background.  Invasive aspergillosis may occur in the setting of severe influenza infections due to viral-induced respiratory epithelium disruption and impaired immune effects, but data are limited. Methods.  A retrospective study was conducted among severe influenza cases requiring medical intensive care unit (ICU) admission at an academic center during the 2015-2016 season. Data collected included respiratory cultures, medical conditions and immunosuppressants, laboratory and radiographic data, and outcomes. A systematic literature review of published cases in the English language of aspergillosis complicating influenza was conducted. Results.  Six (75%) of 8 ICU influenza cases had Aspergillus isolated; 5 were classified as invasive disease. No ICU patient testing negative for influenza infection developed aspergillosis during the study period. Among cases with invasive aspergillosis, influenza infection was type A (H1N1) (n = 2) and influenza B (n = 3). Published and current cases yielded n = 57 (European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group criteria: 37% proven, 25% probable, and 39% possible cases). An increasing number of cases were reported since 2010. Sixty-five percent of cases lacked classic underlying conditions at admission for aspergillosis, 86% had lymphopenia, and 46% died. Conclusions.  Aspergillosis may occur in the setting of severe influenza infections even among immunocompetent hosts. Risks may include influenza A (H1N1) or B infections and viral-induced lymphopenia, although further studies are needed. Prompt diagnosis and antifungal therapy are recommended given high mortality rates.


[h=4]KEYWORDS:[/h] Aspergillus; aspergillosis; influenza; review; superinfection

PMID: 27704024 DOI: 10.1093/ofid/ofw171
[PubMed - in process] Free PMC Article
 
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