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Influenza-Associated Aspergillosis — SCE Infectious Diseases MCQ

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HardFungal InfectionsInfluenza-Associated AspergillosisSCE Infectious Diseases

A previously immunocompetent adult in intensive care with severe influenza develops new pulmonary cavitation, positive BAL culture for Aspergillus fumigatus and positive galactomannan. What is the diagnosis?

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Correct answer: B — Influenza-associated pulmonary aspergillosis

The best answer is “Influenza-associated pulmonary aspergillosis”. Severe influenza damages airway epithelium and is an independent risk state for invasive aspergillosis; classical haematological immunosuppression is not required. Severe influenza is a recognised risk state for invasive pulmonary aspergillosis even without classical neutropenia or transplantation. The combination of a compatible new pulmonary lesion, Aspergillus recovered from lower-respiratory sampling and positive galactomannan supports invasive disease rather than colonisation.

Reference: International expert case definition for influenza-associated pulmonary aspergillosis: https://pmc.ncbi.nlm.nih.gov/articles/PMC7306567/