Quick and reliable galactomannan detection in crude minced lung specimens from haematological patients with suspected invasive fungal infection: results from a case series.
Invasive aspergillosis (IA) is the leading direct or contributory cause of death in patients with haematological malignancies. Early diagnosis remains difficult and often elusive due the heterogeneity of clinical presentations and the low sensitivity of both histological examination and cultures of specimens obtained from patients at risk. We report two cases of IA, both of which lacked both histological and cultural evidence of IA from pulmonary specimens. In both patients, detection of galactomannan (GM) by enzyme immunoassay (EIA) on pulmonary tissue homogenates led to the diagnosis of IA, which was confirmed by Aspergillus DNA (real time PCR). In conclusion, we provide preliminary evidence that lung homogenates may be prepared for GM EIA assays, which may contribute to quick diagnosis of IA on otherwise negative samples. We feel that our results open up the opportunity of a prospective and comparative evaluation of this diagnostic technique.
D'Antonio
D
D
Unità Operativa Complessa di Microbiologia e Virologia Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo, Via Fonte Romana 8, CAP 65125 Pescara, Italy. domenicodantonio@virgilio.it
Manna
A
A
Savini
V
V
Onofrillo
D
D
Di Bonaventura
G
G
Piccolomini
R
R
Parruti
G
G
D000328:Adult; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis*; D001230:Aspergillus / Q000302:isolation & purification; D004271:DNA, Fungal / Q000235:genetics; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D008168:Lung / Q000737:chemistry*; D008297:Male; D008351:Mannans / Q000032:analysis*; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D004271:DNA, Fungal; D008351:Mannans; C012990:galactomannan; D005690:Galactose