Hamam et al reported a clinical algorithm for predicting invasive pulmonary aspergillosis in a patient in the intensive care unit (ICU). This included a review of risk factors for the condition. The authors are from multiple institutions in France.
Patient selection: patient in the ICU with
Triggers to consider:
(1) respiratory deterioration despite mechanical ventilation
(2) fever despite antibiotics >= 3 days
Risk factors may include:
(1) ANC < 500 per µL for > 10 days
(2) receipt of allogeneic stem cell transplant
(3) corticosteroid therapy > 0.3 mg per kg per day for > 3 weeks
(4) therapy with T-cell immunosuppressant for > 90 days
(5) immunodeficiency
(6) ibrutinib therapy (a kinase inhibitor)
(7) underlying cancer treated with cytotoxic agents
(8) COPD
(9) viral respiratory disease
(10) cirrhosis or hepatic failure
(11) diabetes
(12) chronic alcohol use
(13) cardiac surgery
