Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis
IntroductionInvasive’ pulmonary aspergillosis (IPA) has been one of the major causes of mortality in immunocompromised patients. The gold standard method for a diagnosis of IPA is histopathological examination of the lung tissue; however, post-procedural bleeding limits the feasibility of lung biops...
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Frontiers Media S.A.
2018-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fped.2018.00031/full |
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| author | Nattachai Anantasit Nattachai Anantasit Noramon Nuntacharruksa Pimpin Incharoen Aroonwan Preutthipan |
| author_facet | Nattachai Anantasit Nattachai Anantasit Noramon Nuntacharruksa Pimpin Incharoen Aroonwan Preutthipan |
| author_sort | Nattachai Anantasit |
| collection | DOAJ |
| description | IntroductionInvasive’ pulmonary aspergillosis (IPA) has been one of the major causes of mortality in immunocompromised patients. The gold standard method for a diagnosis of IPA is histopathological examination of the lung tissue; however, post-procedural bleeding limits the feasibility of lung biopsy. The European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and The National Institute of Allergy and Infectious Disease Mycoses Study Group (EORTC/MSG) defined IPA. The objective of this study was to validate the EORTC/MSG 2008 definition of IPA, compared with histopathology in the pediatric population.MethodsHistopathological examinations of lung tissues of children aged 1 month–18 years with respiratory tract infection at the time of obtaining biopsy were retrieved. Retrospective chart reviews for clinical characteristics were performed. IPA diagnosis was classified according to the EORTC/MSG 2008 definition.ResultsDuring the 10-year period, there were 256 lung tissues, of which 58 specimens were suspected to have pulmonary infection. Fourteen patients (24%) were noted to have IPA. Seven patients (50%) with proven IPA were classified as probable, while the remaining 50% were classified as possible, and none were classified as no IPA, by using EORTC/MSG 2008 definition. Other 44 specimens demonstrated 14 (32%), 14 (32%), and 16 (36%) were classified as probable, possible, and no IPA, respectively. When comparing probable or possible IPA with no IPA, we found that the EORTC/MSG 2008 definition had 100% sensitivity, 36% specificity, 33% positive predictive value, and 100% negative predictive value in diagnosis of IPA.ConclusionOur study illustrated that the EORTC/MSG 2008 definition provided an excellent sensitivity but low specificity for diagnosing IPA. |
| first_indexed | 2024-04-12T04:23:39Z |
| format | Article |
| id | doaj.art-ab5ea9ecfe4f458cac3a0cbe000555c3 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-12T04:23:39Z |
| publishDate | 2018-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-ab5ea9ecfe4f458cac3a0cbe000555c32022-12-22T03:48:10ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602018-02-01610.3389/fped.2018.00031327244Clinical and Pathological Correlation in Pediatric Invasive Pulmonary AspergillosisNattachai Anantasit0Nattachai Anantasit1Noramon Nuntacharruksa2Pimpin Incharoen3Aroonwan Preutthipan4Division of Pediatric Pulmonology, Department of Pediatric, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Pediatric Critical Care, Department of Pediatric, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Pediatric Pulmonology, Department of Pediatric, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Pediatric Pulmonology, Department of Pediatric, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandIntroductionInvasive’ pulmonary aspergillosis (IPA) has been one of the major causes of mortality in immunocompromised patients. The gold standard method for a diagnosis of IPA is histopathological examination of the lung tissue; however, post-procedural bleeding limits the feasibility of lung biopsy. The European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and The National Institute of Allergy and Infectious Disease Mycoses Study Group (EORTC/MSG) defined IPA. The objective of this study was to validate the EORTC/MSG 2008 definition of IPA, compared with histopathology in the pediatric population.MethodsHistopathological examinations of lung tissues of children aged 1 month–18 years with respiratory tract infection at the time of obtaining biopsy were retrieved. Retrospective chart reviews for clinical characteristics were performed. IPA diagnosis was classified according to the EORTC/MSG 2008 definition.ResultsDuring the 10-year period, there were 256 lung tissues, of which 58 specimens were suspected to have pulmonary infection. Fourteen patients (24%) were noted to have IPA. Seven patients (50%) with proven IPA were classified as probable, while the remaining 50% were classified as possible, and none were classified as no IPA, by using EORTC/MSG 2008 definition. Other 44 specimens demonstrated 14 (32%), 14 (32%), and 16 (36%) were classified as probable, possible, and no IPA, respectively. When comparing probable or possible IPA with no IPA, we found that the EORTC/MSG 2008 definition had 100% sensitivity, 36% specificity, 33% positive predictive value, and 100% negative predictive value in diagnosis of IPA.ConclusionOur study illustrated that the EORTC/MSG 2008 definition provided an excellent sensitivity but low specificity for diagnosing IPA.http://journal.frontiersin.org/article/10.3389/fped.2018.00031/fullinvasive pulmonary aspergillosispediatrichistopathologydefinitionsensitivity |
| spellingShingle | Nattachai Anantasit Nattachai Anantasit Noramon Nuntacharruksa Pimpin Incharoen Aroonwan Preutthipan Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis Frontiers in Pediatrics invasive pulmonary aspergillosis pediatric histopathology definition sensitivity |
| title | Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis |
| title_full | Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis |
| title_fullStr | Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis |
| title_full_unstemmed | Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis |
| title_short | Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis |
| title_sort | clinical and pathological correlation in pediatric invasive pulmonary aspergillosis |
| topic | invasive pulmonary aspergillosis pediatric histopathology definition sensitivity |
| url | http://journal.frontiersin.org/article/10.3389/fped.2018.00031/full |
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