[Diagnosis of invasive pulmonary aspergillosis: value of bronchoalveolar lavage galactomannan for immunocompromised patients]

Pathol Biol (Paris). 2010 Feb;58(1):100-3. doi: 10.1016/j.patbio.2009.07.011. Epub 2009 Nov 4.
[Article in French]

Abstract

Invasive pulmonary aspergillosis (IPA) is an emerging disease associated with high mortality. The diagnosis is difficult, based on a combination of elements that are clinical, radiological and biological. For early detection of cases of IPA, during 25 months, we have systematically carried out on the LBA (N=355) of immunocompromised patients (N=313) a determination of Aspergillus galactomannan (GM) by ELISA (PlateliaAspergillus, BioRad). We observed 14 cases of probable API. The sensitivity of GM compared to direct examination (DE) and culture is, respectively, 64% versus 29% and 57%. The determination of GM is definitely more sensitive than the ED. Excellent specificity (98%) allows its implementation as a screening test in patients at risk.

MeSH terms

  • Aspergillus / growth & development
  • Aspergillus / isolation & purification
  • Bronchoalveolar Lavage Fluid / chemistry*
  • Enzyme-Linked Immunosorbent Assay
  • Galactose / analogs & derivatives
  • Hematologic Neoplasms / complications
  • Humans
  • Immunocompromised Host
  • Invasive Pulmonary Aspergillosis / diagnosis*
  • Invasive Pulmonary Aspergillosis / microbiology
  • Mannans / analysis*
  • Mycology / methods*
  • Neutropenia / complications
  • Postoperative Complications / diagnosis
  • Postoperative Complications / microbiology
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Mannans
  • galactomannan
  • Galactose