[Diagnosis of invasive pulmonary aspergillosis: value of bronchoalveolar lavage galactomannan for immunocompromised patients].
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.
Paugam
A
A
Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. andre.paugam@cch.aphp.fr
Baixench
M-T
MT
Lebuisson
A
A
Dupouy-Camet
J
J
D001230:Aspergillus / Q000254:growth & development / Q000302:isolation & purification; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D004797:Enzyme-Linked Immunosorbent Assay; D005690:Galactose / Q000031:analogs & derivatives; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D008351:Mannans / Q000032:analysis*; D009172:Mycology / Q000379:methods*; D009503:Neutropenia / Q000150:complications; D011183:Postoperative Complications / Q000175:diagnosis / Q000382:microbiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D008351:Mannans; C012990:galactomannan; D005690:Galactose