{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T21:31:39Z","timestamp":1774560699680,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health Research Institutes, Taiwan","award":["IV-107-PP-08, IV-108-PP-08, IV-109-PP-08."],"award-info":[{"award-number":["IV-107-PP-08, IV-108-PP-08, IV-109-PP-08."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016\u20132019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC\/MSG-defined host factors. The mean time from influenza diagnosis to Aspergillus growth was 4.4 days, and 20 (83.3%) developed IAPA within seven days after influenza diagnosis. All patients were treated in intensive care units and all but one (95.8%) received mechanical ventilation. Aspergillus tracheobronchitis was evident in 6 (31.6%) of 19 patients undergoing bronchoscopy. Positive galactomannan testing of either serum or bronchoalveolar lavage was noted in all patients. On computed tomography imaging, IAPA was characterized by peribronchial infiltrates, multiple nodules, and cavities superimposed on ground-glass opacities. Pure Aspergillus growth without bacterial co-isolation in culture was found in 17 (70.8%) patients. A. fumigatus (15, 62.5%), A. flavus (6, 25.0%), and A. terreus (4, 16.7%) were the major causative species. Three patients had mixed Aspergillus infections due to two species, and two had mixed azole-susceptible and azole-resistant A. fumigatus infection. All patients received voriconazole with an all-cause mortality of 41.6%. Of 14 survivors, the mean duration of antifungal use was 40.5 days. In conclusion, IAPA is an early and rapidly deteriorating complication following influenza that necessitates clinical vigilance and prompt diagnostic workup.<\/jats:p>","DOI":"10.3390\/jof8010049","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T01:14:02Z","timestamp":1641518042000},"page":"49","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016\u20132019"],"prefix":"10.3390","volume":"8","author":[{"given":"Chi-Jung","family":"Wu","sequence":"first","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70403, Taiwan"},{"name":"Department of Internal Medicine, Division of Infectious Diseases, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1552-1082","authenticated-orcid":false,"given":"Cong-Tat","family":"Cia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsuan-Chen","family":"Wang","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70403, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7954-4278","authenticated-orcid":false,"given":"Chang-Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"},{"name":"Department of Medicine, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-8477","authenticated-orcid":false,"given":"Wei-Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen-Chieh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2742-3268","authenticated-orcid":false,"given":"Chih-Cheng","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Critical Care Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8470-6590","authenticated-orcid":false,"given":"Po-Lan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Chest Medicine and Respiratory Care, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin-Min","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Chest Medicine and Respiratory Care, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-I","family":"Hsieh","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70403, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pui-Ching","family":"Choi","sequence":"additional","affiliation":[{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 70403, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7497-149X","authenticated-orcid":false,"given":"Wen-Chien","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"},{"name":"Department of Medicine, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/S2213-2600(18)30274-1","article-title":"Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: A retrospective cohort study","volume":"6","author":"Schauwvlieghe","year":"2018","journal-title":"Lancet Respir. 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