{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:22:38Z","timestamp":1790745758248,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,6,9]],"date-time":"2019-06-09T00:00:00Z","timestamp":1560038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Autopsy studies show that <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> is among the most commonly missed diagnoses in critically ill patients. And, because of lack of unequivocal diagnostic criteria, a timely diagnosis remains challenging. We investigate the epidemiology of and the clinical risk factors for <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> in critically ill patients. We conducted a retrospective, observational study of all consecutive <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> patients with evidence of <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> in the postmortem examination. During the period of the study (25\u00a0years), 893 postmortem examinations were performed in the <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>. Twenty\u2010five patients (2.8%) were diagnosed with <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> in autopsy. Only ten (40%) were classified as <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> ante\u2010mortem, based on the initiation of antifungal treatment. The most common comorbid conditions were corticosteroid treatment (n\u00a0=\u00a014, 56%), chronic obstructive pulmonary disease (<jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>) (n\u00a0=\u00a011, 44%), immunosuppression (n\u00a0=\u00a06, 24%) and haematological malignancy (n\u00a0=\u00a05, 20%). Twenty\u2010three patients (92%) had three or more risk factors for <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>. Critically ill patients with pulmonary infiltrates, treated with high doses intravenous corticosteroids (even for a short period of time), particularly <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> patients who developed worsening respiratory insufficiency despite appropriate treatment were at the highest risk of <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/myc.12927","type":"journal-article","created":{"date-parts":[[2019,6,9]],"date-time":"2019-06-09T22:54:35Z","timestamp":1560120875000},"page":"673-679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Invasive aspergillosis in critically ill patients: An autopsy study"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3573-9943","authenticated-orcid":false,"given":"Eva E.","family":"Tejerina","sequence":"first","affiliation":[{"name":"Intensive Care Unit 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