{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:18:37Z","timestamp":1790381917842,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Invasive pulmonary aspergillosis (IPA), once limited to immunocompromised patients, is now a severe complication in critically ill ICU patients without classic risk factors. Due to the difficulty of obtaining histological evidence, diagnosis relies on poorly tested algorithms in real-world settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective multicenter (n = 9) cohort study including 202 patients with IPA. Patients were classified using a multistep process based on the EuropeanOrganization- for-the-Research-and-Treatment-of-Cancer\/Mycosis-Study Group (EORTC-MSG), Invasive-Fungal-Diseases-in-Adult-Patients-in-Intensive-Care-Unit (FUNDICU), Aspergillus-ICU (Asp-ICU), and Asp-ICU with biomarkers (Asp-ICU-BM) criteria. We then evaluated the predictive performance of these criteria against the clinical cohort and histologically proven cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 202 patients, 78 had EORTC-MSG host factors and were classified accordingly, with EORTC-MSG criteria achieving 100% agreement in identifying clinical and histologically proven cases. In 112 ICU patients without EORTC-MSG host factors, overall agreement was 53% for FUNDICU, 4% for Asp-ICU, and 26% for Asp-ICU-BM versus the clinical cohort. Validation against histologically proven cases showed FUNDICU had 44% sensitivity and 75% specificity, Asp-ICU 6% sensitivity and 100% specificity, and Asp-ICU-BM 28% sensitivity and 63% specificity. Adding acute respiratory distress syndrome (ARDS) and post-cardiac surgery to the FUNDICU criteria improved sensitivity to 97% with a specificity of 63%. The remaining 12 patients lacked EORTC-MSG host factors and were not in the ICU, highlighting a novel classification system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>EORTC-MSG and FUNDICU IPA classification systems are useful for the assignment of most patients with IPA. Incorporating postoperative complications after cardiac surgery and ARDS enhanced the diagnostic accuracy of FUNDICU.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae633","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T08:30:41Z","timestamp":1734683441000},"page":"1080-1087","source":"Crossref","is-referenced-by-count":19,"title":["Performance of Diagnostic Algorithms in Patients With Invasive Pulmonary Aspergillosis"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6266-0512","authenticated-orcid":false,"given":"Stefan","family":"Hatzl","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]},{"name":"BioTechMed-Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Geiger","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1977-2196","authenticated-orcid":false,"given":"Lisa","family":"Kriegl","sequence":"additional","affiliation":[{"name":"BioTechMed-Graz , Graz ,","place":["Austria"]},{"name":"Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Scholz","sequence":"additional","affiliation":[{"name":"Emergency Department, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-5695","authenticated-orcid":false,"given":"Alexander C","family":"Reisinger","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Kreuzer","sequence":"additional","affiliation":[{"name":"Emergency Department, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Fruhwald","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology and Intensive Care Medicine II, Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"W\u00f6lfler","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Reinisch","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]},{"name":"Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-6128","authenticated-orcid":false,"given":"Dirk","family":"von Lewinski","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Medical University of Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Schilcher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Landeskrankenhaus S\u00fcdsteiermark , Wagna 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