Evaluation of a quantitative serumAspergillus fumigatus-specific IgM assay for diagnosis of chronic pulmonary aspergillosis

2018 ◽  
Vol 12 (11) ◽  
pp. 2566-2572 ◽  
Author(s):  
Yake Yao ◽  
Hua Zhou ◽  
Yihong Shen ◽  
Qing Yang ◽  
Jian Ye ◽  
...  
Keyword(s):  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Kwizera ◽  
Andrew Katende ◽  
Felix Bongomin ◽  
Lydia Nakiyingi ◽  
Bruce J. Kirenga
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Diagnostic Criteria ◽  
Tertiary Care ◽  
Chest Imaging ◽  
Resource Limited Settings ◽  
Pulmonary Aspergillosis ◽  
Resource Limited ◽  
Chronic Pulmonary Aspergillosis ◽  
Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

scholarly journals Performance of LDBio Aspergillus WB and ICT Antibody Detection in Chronic Pulmonary Aspergillosis

2021 ◽  
Vol 7 (4) ◽  
pp. 311
Author(s):  
Anna Rozaliyani ◽  
Findra Setianingrum ◽  
Sresta Azahra ◽  
Asriyani Abdullah ◽  
Ayu Eka Fatril ◽  
...  
Keyword(s):  
Receiver Operating Curve ◽  
Antibody Detection ◽  
Pulmonary Aspergillosis ◽  
Comparative Performance ◽  
Tuberculosis Patients ◽  
Chronic Pulmonary Aspergillosis ◽  
Screening Assays ◽  
Roc Area ◽  
Flow Detection ◽  
Sensitivity Specificity

The detection of Aspergillus antibody has a key role in the diagnosis of chronic pulmonary aspergillosis. Western blot (WB) and immunochromatography (ICT) lateral flow detection of Aspergillus antibody can be used as confirmatory and screening assays but their comparative performance in TB patients is not known. This study investigated the performance of these assays among 88 post-tuberculosis patients with suspected CPA. Sensitivity, specificity, receiver operating curve (ROC), area under-curve (AUC) and the agreement between two assays were evaluated. Both WB and ICT showed good sensitivity (80% and 85%, respectively) for detection of Aspergillus antibodies. Substantial agreement (0.716) between these assays was also obtained. The highest AUC result (0.804) was achieved with the combination of WB and ICT. The global intensity of WB correlated with the severity of symptoms in CPA group (p = 0.001). The combination of WB and ICT may increase specificity in CPA diagnosis.

scholarly journals Bronchoalveolar lavage galactomannan for the diagnosis of chronic pulmonary aspergillosis

2012 ◽  
Vol 50 (8) ◽  
pp. 811-817 ◽  
Author(s):  
Koichi Izumikawa ◽  
Yoshihiro Yamamoto ◽  
Tomo Mihara ◽  
Takahiro Takazono ◽  
Yoshitomo Morinaga ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Impact of liposomal amphotericin B therapy on chronic pulmonary aspergillosis

2016 ◽  
Vol 73 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Pippa J. Newton ◽  
Chris Harris ◽  
Julie Morris ◽  
David W. Denning
Keyword(s):  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Liposomal Amphotericin B ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Chronic Pulmonary Aspergillosis Misdiagnosed as Smear-Negative Pulmonary Tuberculosis in a TB Clinic in Nigeria

2018 ◽  
Vol 26 (10) ◽  
pp. 1-5 ◽  
Author(s):  
Titilola Gbaja-Biamila ◽  
Felix Bongomin ◽  
Nicholas Irurhe ◽  
Augustina Nwosu ◽  
Rita Oladele
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis ◽  
Smear Negative

scholarly journals St. George’s Respiratory Questionnaire (SGRQ) sebagai Alat Bantu Diagnostik serta Prediktor Terjadinya Chronic Pulmonary Aspergillosis (CPA) pada Pasien Tuberkulosis Paru Pasca Terapi

2021 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
William S. Wangko ◽  
Indra Kurniawan ◽  
Maarthen C. P. Wongkar ◽  
Agung Nugroho ◽  
Efata B Polii
Keyword(s):  
Diagnostic Tool ◽  
Predictive Value ◽  
Clinical Signs ◽  
Clinical Score ◽  
Pulmonary Aspergillosis ◽  
Cross Sectional ◽  
Lung Tuberculosis ◽  
St George's Respiratory Questionnaire ◽  
Chronic Pulmonary Aspergillosis ◽  
Post Therapy

Abstract: Patients of post therapy lung tuberculosis (TB) that still have permanent or worsened clinical signs might be caused by chronic pulmonary aspergillosis (CPA). Diagnosis of CPA is difficult to confirmed without complete supporting tests. This study was aimed to establish whether Saint George’s Respiratory Questionnaire (SGRQ) could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients. This was an analytical observational study with a cross sectional design. There were 72 patients who had negative Gene Xpert sputum; 34.7% with positive Aspergillus-specific IgG. Their clinical signs were evaluated with SGRQ. The results showed that there was a very significant relationship between clinical score and CPA (p<0.0001). The lower the clinical score the less the probability of CPA. In this analysis we determined the diagnosis value of clinical score with a probability cut-off point = 0.5 which led to clinical score cut-off point of 45.6 with further results, as follows: sensitivity 68.0%; specificity 95.7%; positive predictive value 89.5%; negative predictive value 84.9%; OR 47.8, and CI 95% (9,2-248,2). In conclusion, SGRQ could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients.Keywords: post therapy lung TB; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)  Abstrak: Pasien TB paru pasca terapi yang masih memperlihatkan gejala klinis menetap atau bahkan memberat dapat disebabkkan oleh adanya chronic pulmonary aspergillosis (CPA). Diagnosis CPA sulit ditegakkan tanpa adanya pemeriksaan penunjang yang lengkap. Penelitian ini bertujuan untuk menentukan apakah Saint George’s Respiratory Questionnaire (SGRQ) dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Hasil penelitian mendapatkan 72 pasien dengan sputum Gene Xpert negatif (34,7% dengan positif IgG Aspergillus) dilakukan penilaian skor klinis menggunakan SGRQ. Hasil uji menunjukkan terdapat hubungan sangat bermakna antara skor klinis dengan terjadinya CPA (p<0,0001). Makin rendah skor klinis makin kecil peluang terjadinya CPA. Melalui analisis ini dapat ditentukan nilai diagnosis skor klinis SGRQ dengan mengambil titik potong peluang = 0,5. Nilai peluang = 0,5 memberikan titik potong skor klinis = 45,6.  Dengan titik potong skor klinis SGRQ = 45,6 diperoleh nilai-nilai diagnosis sebagai berikut: Sensitivitas = 68,0%; Spesifisitas = 95,7%; Nilai Prediksi Positif = 89,5%; Nilai Prediksi Negatif = 84,9%; OR = 47,8 dengan CI 95% (9,2-248,2). Simpulan penelitian ini ialah SGRQ dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi.Kata kunci: tuberkulosis paru pasca terapi; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)

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