caa a22 4500 463256115 CHVBK 20180405153355.0 cr unu---uuuuu 170326e20070301xx s 000 0 eng 10.1007/s00277-006-0204-3 doi (NATIONALLICENCE)springer-10.1007/s00277-006-0204-3 Usefulness of the MSG/IFICG/EORTC diagnostic criteria of invasive pulmonary aspergillosis in the clinical management of patients with acute leukaemia developing pulmonary infiltrates [Elektronische Daten] [Erika Borlenghi, Chiara Cattaneo, Maria Capucci, Angelo Pan, Giulia Quaresmini, Fabio Franco, Luigi Grazioli, Gian Carosi, Giuseppe Rossi] Invasive pulmonary aspergillosis (IPA) is a frequently fatal complication in patients with acute leukaemia. Because diagnosis is still difficult, non-invasive diagnostic criteria were recently proposed by MSG/IFICG/EORTC for study purposes. We have analysed their usefulness in the clinical management of acute leukaemic patients with pulmonary infiltrates. Twenty-seven infiltrates developed during 174 chemotherapy cycles given to 50 consecutive patients. According to diagnostic criteria, IPA was diagnosed in 42% of patients and 77.8% of pulmonary infiltrates. AML diagnosis and the first induction cycle were significant risk factors. "Proven” IPA was rare, occurring in one patient (2%). The diagnosis of "probable” IPA was made in seven patients (14%) and was strongly supported by the significant association of characteristic radiological lesions ("major” clinical criterion) with the positivity of one microbiological criterion (P = 0.026). Conversely, "possible” IPA was frequent (26%) because its pertinent diagnostic criteria were fulfilled in 48.1% of pulmonary infiltrates. However, in 84.6% of cases, the diagnosis of "possible IPA” aspecifically derived from the association of two conditions, a new pulmonary infiltrate with symptoms of lower respiratory tract infection ("minor clinical criterion”), together with the definition of "susceptible” host, which applied to 100% of our leukaemic patients. We conclude that, according to MSG/IFICG/EORTC criteria, a high number of pulmonary infiltrates would be diagnosed as IPA, but only a diagnosis of "proven/probable” IPA should be considered reliable in the clinical management of suspected IPA. Springer-Verlag, 2006 Aspergillosis nationallicence Acute leukaemia nationallicence Diagnostic criteria nationallicence Borlenghi Erika U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut Cattaneo Chiara U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut Capucci Maria U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut Pan Angelo Istituto di Malattie Infettive e Tropicali, Università degli Studi, Brescia, Italy aut Quaresmini Giulia U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut Franco Fabio Servizio di I Radiologia, Spedali Civili, Brescia, Italy aut Grazioli Luigi Servizio di I Radiologia, Spedali Civili, Brescia, Italy aut Carosi Gian Istituto di Malattie Infettive e Tropicali, Università degli Studi, Brescia, Italy aut Rossi Giuseppe U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut Annals of Hematology Springer-Verlag 86/3(2007-03-01), 205-210 0939-5555 86:3<205 2007 86 277 https://doi.org/10.1007/s00277-006-0204-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00277-006-0204-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Borlenghi Erika U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut NATIONALLICENCE 700 1- Cattaneo Chiara U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut NATIONALLICENCE 700 1- Capucci Maria U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut NATIONALLICENCE 700 1- Pan Angelo Istituto di Malattie Infettive e Tropicali, Università degli Studi, Brescia, Italy aut NATIONALLICENCE 700 1- Quaresmini Giulia U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut NATIONALLICENCE 700 1- Franco Fabio Servizio di I Radiologia, Spedali Civili, Brescia, Italy aut NATIONALLICENCE 700 1- Grazioli Luigi Servizio di I Radiologia, Spedali Civili, Brescia, Italy aut NATIONALLICENCE 700 1- Carosi Gian Istituto di Malattie Infettive e Tropicali, Università degli Studi, Brescia, Italy aut NATIONALLICENCE 700 1- Rossi Giuseppe U.O. Ematologia, Spedali Civili, Piazzale Spedali Civili, 1, 25100, Brescia, Italy aut NATIONALLICENCE 773 0- Annals of Hematology Springer-Verlag 86/3(2007-03-01), 205-210 0939-5555 86:3<205 2007 86 277 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer