title: How to manage aspergillosis in non-neutropenic intensive care unit patients.
abstract: Invasive aspergillosis has been mainly reported among immunocompromised patients during prolonged periods of neutropenia. Recently, however, non-neutropenic patients in the ICU population have shown an increasing risk profile for aspergillosis. Associations with chronic obstructive pulmonary disease and corticosteroid therapy have been frequently documented in this cohort. Difficulties in achieving a timely diagnosis of aspergillosis in non-neutropenic patients is related to the non-specificity of symptoms and to lower yields with microbiological tests compared to neutropenic patients. Since high mortality rates are typical of invasive aspergillosis in critically ill patients, a high level of suspicion and prompt initiation of adequate antifungal treatment are mandatory. Epidemiology, risk factors, diagnostic algorithms, and different approaches in antifungal therapy for invasive aspergillosis in non-neutropenic patients are reviewed.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Elda
authors.initials: E
authors.lastname: Righi
authors.forename: Gennaro
authors.initials: G
authors.lastname: De Pascale
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Gaudio
authors.forename: Antonino
authors.initials: A
authors.lastname: Giarratano
authors.forename: Tereesita
authors.initials: T
authors.lastname: Mazzei
authors.forename: Giulia
authors.initials: G
authors.lastname: Morace
authors.forename: Nicola
authors.initials: N
authors.lastname: Petrosillo
authors.forename: Stefania
authors.initials: S
authors.lastname: Stefani
authors.forename: Massimo
authors.initials: M
authors.lastname: Antonelli
mesh_terms: D000305:Adrenal Cortex Hormones / Q000276:immunology / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D021821:Communicable Diseases, Emerging / Q000453:epidemiology; D016638:Critical Illness; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D007362:Intensive Care Units; D009894:Opportunistic Infections; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000276:immunology; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents