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Table 2 The diagnostic framework for IPA in patients with URD

From: Sputum signatures for invasive pulmonary aspergillosis in patients with underlying respiratory diseases (SPARED): study protocol for a prospective diagnostic trial

Host factors

Recent history of neutropenia (< 0.5 × 109 neutrophils/L for > 10 days) temporally related to the onset of infection

Prolonged use of corticosteroids at a mean minimum dose of 0.3 mg/kg/day of prednisone equivalent for > 3 weeks

Treatment with immunosuppressants during the past 90 days

Inherited severe immunodeficiency

Underlying respiratory diseases including chronic pulmonary diseases (COPD, asthma, lung cancer, bronchiectasis, interstitial lung diseases, and cystic fibrosis) and acute pulmonary diseases (bacterial pneumonia, viral pneumonia, and acute bronchitis)

Clinical criteria

The presence of 1 of the following 3 signs on chest computed tomography:

Dense, well circumscribed lesion(s) with or without a halo sign

Air-crescent sign

Cavity on chest computed tomography

Mycological criteria

Cytologic or microscopic evidence of Aspergillus elements or recovery of Aspergillus in sputum or BALF

Positive GM test in serum or BALF