Discordant rise in galactomannan antigenemia in a patient with resolving Aspergillosis, renal failure, and ongoing hemodialysis.
We describe the case of a patient with improving invasive aspergillosis and paradoxically rising serum galactomannan levels in the presence of chronic renal failure and ongoing hemodialysis. Dialysate tested negative for galactomannan, demonstrating the inability of treatments such as hemodialysis to clear Aspergillus antigen from serum. In patients with renal failure and aspergillosis, rising serum galactomannan levels may not necessarily signify progressive infection.
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
Chadi M
CM
El Saleeby
Kim J
KJ
Allison
Katherine M
KM
Knapp
Thomas J
TJ
Walsh
Randall T
RT
Hayden
D000293:Adolescent; D000946:Antigens, Fungal / Q000097:blood / Q000378:metabolism*; D001228:Aspergillosis / Q000150:complications* / Q000382:microbiology; D001231:Aspergillus flavus / Q000302:isolation & purification*; D002908:Chronic Disease; D016469:Fungemia / Q000150:complications* / Q000382:microbiology; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008351:Mannans / Q000097:blood / Q000378:metabolism*; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications*
D000946:Antigens, Fungal; D008351:Mannans; C012990:galactomannan; D005690:Galactose