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Predictors for Invasive Pulmonary Aspergillosis in Cancer Patients

Purpose: To evaluate a patient with a malignant disease and pneumonia for predictors of pulmonary aspergillosis as reported by Hachem et al.

Description

Hachem et al identified clinical and radiologic predictors of invasive pulmonary aspergillosis in a cancer patient. These can help identify patients who may benefit from closer monitoring and more aggressive management for pulmonary aspergillosis. The authors are from M.D. Anderson Cancer Center in Houston and the University of Carabobo in Venezuela.


 

Patient selection: presence of a malignant disease and pneumonia

 

Risk factors for invasive pulmonary aspergillosis:

(1) neutropenia (absolute neutrophil count <= 500 per µL) at the onset of infection

(2) leukemia

(3) cavitary lesion on CT scan

(4) nodular lesion on CT scan

Neutropenia

Nodular Lesion

Cavitary Lesion

Leukemia

Percent with Aspergillus

N

NA

N

N

15%

N

NA

N

Y

44%

Y

N

NA

NA

60%

N

NA

Y

NA

86%

Y

Y

NA

NA

100%

 

The first group is low risk, the second and third intermediate risk, and the final 2 high risk.

 


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Specialty

Objective

ICD-10