Analysis of influencing factors of severe influenza B virus pneumonia complicated with invasive pulmonary aspergillosis
- VernacularTitle:重症乙型流感病毒性肺炎合并侵袭性肺曲霉菌病的影响因素分析
- Author:
Zhigang ZHAO
1
;
Hui LIU
1
;
Hongmei LIU
1
Author Information
- Publication Type:Journal Article
- Keywords: influenza B virus; pneumonia,viralviral; invasive pulmonary aspergillosis; bronchoscopes; galactomannan test
- From: Tianjin Medical Journal 2025;53(7):736-740
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the clinical characteristics and risk factors of severe influenza B viral pneumonia complicated with invasive pulmonary aspergillosis.Methods Forty-six patients with severe influenza B virus pneumonia were collected and divided into the invasive pulmonary aspergillosis(IPA)group(17 cases)and the control group(29 cases)based on whether they were complicated with IPA.The clinical manifestations,laboratory indicators,chest CT imaging findings,bronchoscopic manifestations,broncho alveolar lavage fluid(BALF)culture and metagenomic next-generation sequencing results were compared between the two group.Treatment conditions and final treatment outcomes were also compared between the two groups.Univariate and multivariate Logistic regression analyses were conducted to explore risk factors of severe influenza B virus pneumonia complicated with IPA.Results After treatment,a total of 6 patients died(35.30％),all of whom were in the invasive pulmonary aspergillosis group.In both groups,the symptoms of dyspnea,cough,expectoration and chest pain were more severe,and systemic symptoms such as fatigue,fever and muscle pain were also quite obvious.There were no significant differences in clinical symptoms,combined bacterial infection and hormone use between the two groups.Compared with the control group,white blood cell count,neutrophil count,blood GM test and BALF GM test were higher in the combined group.The proportion of patients with nodules and patchy shadows on imaging and the proportion of patients showing pseudomembrane manifestations under bronchoscopy were higher(P＜0.05).Univariate Logistic regression analysis showed that white blood cell count,GM in BALF,nodules and patchy shadows in lung imaging and pseudomembrane manifestations under bronchoscopy were influencing factors for severe influenza B virus pneumonia combined with invasive pulmonary aspergillosis(P＜0.05).Multivariate Logistic regression analysis showed that GM≥1 in BALF and pseudomembrane manifestations under bronchoscopy were risk factors for severe influenza B virus pneumonia combined with invasive pulmonary aspergillosis(P＜0.05).Conclusion When GM test level of BALF in patients with severe influenza B virus pneumonia is≥1 and pseudomembrane manifestations are seen under bronchoscopy,the possibility of combined invasive pulmonary aspergillus infection should be highly vigilant.
