Intensive Care Medicine

, Volume 22, Issue 12, pp 1315–1322

Outcome of ICU treatment in invasive aspergillosis

  • J. J. W. M. Janssen
  • R. J. M. Strack van Schijndel
  • E. H. van der Poest Clement
  • G. J. Ossenkoppele
  • L. G. Thijs
  • P. C. Huijgens
Original

DOI: 10.1007/BF01709544

Cite this article as:
Janssen, J.J.W.M., Strack van Schijndel, R.J.M., van der Poest Clement, E.H. et al. Intensive Care Med (1996) 22: 1315. doi:10.1007/BF01709544

Abstract

Objective

To assess the outcome of intensive care treatment in invasive aspergillosis.

Design

Retrospective study.

Setting

University Hospital, Medical Intensive Care Unit (ICU).

Patients

Twenty-five patients with invasive aspergillosis who were admitted to the medical ICU in a 5 1/2 year period. Twenty-two had received high-dose chemotherapy for (mainly hematologic) malignancies, one had been treated with cyclosporine and prednisolone for systemic lupus erythematosus, one with high-dose methylprednisolone for polyarteritis nodosa and one had an ARDS after near-drowning.

Measurements and results

The medical records were reviewed for patient and disease characteristics, outcome, reasons for admission to the ICU, supportive care and antifungal therapy as well as for the results of cultures and autopsy. Out of 25 patients, a definite ante mortem diagnosis could be established in seven. When autopsied patients were included, a total of 15 suffered from proven invasive aspergillosis. Although standard antifungal treatment and maximal available supportive care were given, 23 of 25 patients (92%) died after a mean of 15 (1–51) days in the ICU. Both patients who recovered had received high-dose chemotherapy for hematologic malignancy and showed bone marrow recovery and/or had a localized pulmonary infection.

Conclusions

In patients with highly suspected or proven invasive aspergillosis, admission to an ICU and mechanical ventilation should be considered in cases of localized infection and obvious signs of hematologic recovery. In most other circumstances ICU admission for mechanical ventilation does not seem to improve survival.

Key words

Aspergillosis Intensive care Respiratory failure 

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • J. J. W. M. Janssen
    • 1
  • R. J. M. Strack van Schijndel
    • 1
  • E. H. van der Poest Clement
    • 1
  • G. J. Ossenkoppele
    • 2
  • L. G. Thijs
    • 1
  • P. C. Huijgens
    • 2
  1. 1.Medical Intensive Care UnitAcademisch Ziekenhuis Vrije UniversiteitAmsterdamThe Netherlands
  2. 2.Department of HematologyAcademisch, Ziekenhuis Vrije UniversiteitAmsterdamThe Netherlands
  3. 3.Department of Internal MedicineAcademisch Ziekenhuis Vrije UniversiteitAmsterdamThe Netherlands