Invasive aspergillosis and mucormycosis typically affect individuals who are immunocompromised and/or have established risk factors,1–5 but cases are also being reported in critically ill patients admitted to the ICU.2–4 In fact, almost half of all cases of invasive aspergillosis and a high proportion of mucormycosis cases are diagnosed or treated in the critical care setting.1,2
The impact of invasive fungal infections in the ICU
Invasive fungal infections continue to pose a significant threat to patients and are associated with extremely high mortality.6-9 Early diagnosis and prompt administration of antifungal therapy are key to improving patient outcomes, including survival.10-12
ICU patients that present with invasive fungal infections may be mildly immunocompromised, or even have no immunosuppression or underlying diseases at all.4,13 This is in contrast to classic diagnostic definitions (EORTC/MSG), which were developed primarily for patients with cancer or undergoing stem cell or solid organ transplant.3–5,14 The ICU patient population may fall outside of those standard definitions,13–15 adding to the diagnostic complexity in an already challenging environment.
Both acute and chronic conditions can predispose non-neutropenic patients to invasive aspergillosis and mucormycosis.1,13,16–20 For example, around one-fifth of ICU patients with severe influenza and one-sixth of those with severe alcoholic hepatitis develop invasive aspergillosis.16–18 Other conditions that may increase the risk of invasive aspergillosis include COPD, ARDS, and liver cirrhosis,13,19,20 while immunocompetent patients with traumatic wounds may go on to develop mucormycosis.1
Underlying conditions in ICU patients with invasive aspergillosis (n=297)3
Adapted from reference 3.
Visit the support and resources section to find our latest videos and materials for CRESEMBA ®
See the clinical data for CRESEMBA® in invasive aspergillosis (SECURE trial)
See the clinical data for CRESEMBA® in mucormycosis (VITAL trial)
Meet Ruth, our hypothetical ICU patient with suspected invasive aspergillosis post influenza
Download this guide to support your diagnosis and treatment of patients with invasive aspergillosis in the ICU
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