Aspergillose invasive en réanimation

Authors

  • Louise Chantelot Service de Médecine intensive réanimation, Hopital Henri Mondor
  • Sarah Dellière 1. AP-HP, Hôpital Saint-Louis, Laboratoire de Parasitologie-Mycologie, 75010, Paris, France. 2. Institut Pasteur, Immunobiology of Aspergillus, Université de Paris Cité, 75015, Paris, France
  • Fanny Lanternier 1. AP-HP, Hopitaux Universitaires Necker, service de Maladies Infectieuses et tropicales, 75015, Paris, France. 2. Université Paris Cité, Institut Pasteur, National Reference Center for Invasive Mycoses and Antifungals,  Mycology Translational Research Group, Mycology Department, Institut Pasteur, Paris, France.
  • Nicolas de Prost 1. AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Médecine Intensive Réanimation, F-94010, Créteil, France. 5. Université Paris-Est-Créteil (UPEC), Créteil, France. 7. IMRB INSERM U955, Team « Viruses, Hepatology, Cancer », Créteil, France
  • Alexandra Serris AP-HP, Hopitaux Universitaires Necker, service de Maladies Infectieuses et tropicales, 75015, Paris, France

DOI:

https://doi.org/10.37051/mir-34-002089

Keywords:

invasive pulmonary aspergillosis, intensive care

Abstract

Invasive pulmonary aspergillosis (API) is a rare fungal infection, typically caused by a saprophyte mold of our environment. This condition primarily affects immunocompromised patients such as neutropenic patients and stem cell recipients. In intensive care, this infection has been linked to acute respiratory distress syndrome (ARDS), as well as other conditions, including chronic obstructive pulmonary disease (COPD) and viral respiratory infections, including influenza and COVID-19. The mortality rate associated remains alarmingly high, ranging from 50 to 80%.

Diagnostic and therapeutic management is based on the recommendations of the European Organisation for Research and Treatment of Cancer (EORTC) revised in 2019. A new consensus specific to intensive care unit patients has been established to facilitate the diagnosis of patients. Early and systematic screening for IPA in at-risk populations seems essential, as treatment initiation correlates with prognosis. Indirect diagnostic markers such as galactomannan antigen should be included in the algorithm, considering their limitations in the ICU setting. First-line treatment is based on the administration of voriconazole or isavuconazole, with particular attention to dosage due to the significant inter- and intra-individual variability in our patients.

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Published

2025-07-25

How to Cite

Chantelot, L., Dellière, S., Lanternier, F., de Prost, N., & Serris, A. (2025). Aspergillose invasive en réanimation. Médecine Intensive Réanimation, 34(2). https://doi.org/10.37051/mir-34-002089

Issue

Vol. 34 No. 2 (2025)

Section

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