title: Current issues in the clinical management of invasive aspergillosis--the AGIHO, DMykG, ÖGMM and PEG web-based survey and expert consensus conference 2009.
abstract: The objectives of this study were to identify unsolved issues in the management of invasive aspergillosis, identify controversies and achieve consensus. The German Speaking Mycological Society (Deutschsprachige Mykologische Gesellschaft, DMykG) invited other German infectious diseases (ID) and mycological societies to submit unsolved issues concerning the diagnosis and treatment of invasive aspergillosis. Based on these contributions, a digital web-based questionnaire of 12 questions on Aspergillus spp. was designed to be completed by experts of the participating societies. Controversial results were identified by a mathematical model and were discussed at a consensus conference during the 43rd Annual Meeting of the DMykG in Cologne, Germany. Forty-two individuals completed the questionnaire. Analysis showed a strong consensus on effective preventive measures, choice of antifungal agents for pre-emptive, empiric and targeted treatment, as well as the evaluation of early chest CT control scans as a measure of treatment response assessment. Opinions on the indication for a pulmonary biopsy of a halo sign in high-risk neutropenic patients and on the role of Aspergillus spp. PCR as well as galactomannan from serum in the assessment of treatment duration diverged in spite of discussion such that a consensus could not be reached. Using a recently published two-step approach - web-based survey plus classical panel discussion - expert consensus was achieved on 10 of 12 questions concerning the diagnosis and treatment of invasive aspergillosis.
authors.affiliation: 1st Department of Internal Medicine, University of Cologne, Cologne, Germany.
authors.forename: M J G T
authors.initials: MJ
authors.lastname: Rüping
authors.forename: J J
authors.initials: JJ
authors.lastname: Vehreschild
authors.forename: A
authors.initials: A
authors.lastname: Groll
authors.forename: C
authors.initials: C
authors.lastname: Lass-Flörl
authors.forename: H
authors.initials: H
authors.lastname: Ostermann
authors.forename: M
authors.initials: M
authors.lastname: Ruhnke
authors.forename: O A
authors.initials: OA
authors.lastname: Cornely
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage; D001230:Aspergillus / Q000302:isolation & purification; D001706:Biopsy / Q000706:statistics & numerical data; D018890:Chemoprevention / Q000379:methods; D003245:Consensus Statements as Topic; D003625:Data Collection; D005858:Germany; D006801:Humans; D020407:Internet; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000517:prevention & control*; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
chemical_list: D000935:Antifungal Agents