title: An aspergillus immunodiffusion test in the early diagnosis of aspergillosis in adult leukemia patients.
abstract: An Aspergillus fumigatus immunodiffusion test was performed biweekly for one year on 80 hospitalized patients with acute leukemia to determine if serologic conversion accompanied clinical aspergillosis. A micro-ouchterlony technique with agarose was used. The antigens were prepared from concentrated A. fumigatus culture filtrates and the sera were concentrated 3-fold before testing. Of 80 patients, 10 were proved at autopsy, lung biopsy, or closed space culture to have invasive aspergillosis. Six of 10 patients converted from a negative to a positive immunodiffusion test, whereas a seventh patient's weakly positive test became strongly positive. Three patients with documented aspergillosis did not develop a positive immunodiffusion test. Four of the patients who converted from a negative to a positive test were treated early and successfully with amphotericin B. A fifth patient developed immunodiffusion test antibody late in the course and died despite therapy. A sixth patient died of concomitant mucormycosis despite early therapy. Six additional patients who converted from a negative to a positive immunodiffusion test could not be evaluated because of inadequate documentation of aspergillosis. In severely immunosuppressed patients, our immunodiffusion test proved to be a specific but not always a sensitive test for aspergillosis. In 4 patients, biweekly tests showed conversion associated with invasive aspergillosis, which was diagnosed early and treated successfully.
mesh_terms: D000208:Acute Disease; D000666:Amphotericin B / Q000627:therapeutic use; D000908:Antibodies, Fungal / Q000032:analysis; D006801:Humans; D005779:Immunodiffusion; D007165:Immunosuppression Therapy; D007938:Leukemia / Q000150:complications*; D008172:Lung Diseases, Fungal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000908:Antibodies, Fungal; D000666:Amphotericin B