Serum galactomannan antigen test combined with chest computed tomography for invasive pulmonary aspergillosis in pediatric patients after hematopoietic stem cell transplantation; Methodological issues on early diagnostic value

2020 ◽  
Vol 34 (3) ◽  
Author(s):  
Siamak Sabour
Keyword(s):  
Pediatric Patients ◽  
Invasive Pulmonary Aspergillosis ◽  
Diagnostic Value ◽  
Antigen Test ◽  
Methodological Issues ◽  
Pulmonary Aspergillosis ◽  
Hematopoietic Stem ◽  
Chest Computed Tomography ◽  
Galactomannan Antigen ◽  
Early Diagnostic

scholarly journals Utility of serum galactomannan antigen testing combined with chest computed tomography for early diagnosis of invasive pulmonary aspergillosis in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment

2018 ◽  
Vol 47 (2) ◽  
pp. 783-790 ◽  
Author(s):  
Xiaoning Wang ◽  
Guili Guo ◽  
Ruibo Cai ◽  
Pengcheng He ◽  
Mei Zhang
Keyword(s):  
Early Diagnosis ◽  
Febrile Neutropenia ◽  
Hematological Malignancies ◽  
Invasive Pulmonary Aspergillosis ◽  
Chest Ct ◽  
Antifungal Drugs ◽  
Control Group ◽  
Pulmonary Aspergillosis ◽  
Galactomannan Antigen ◽  
Observational Group

Objective To investigate the value of serum galactomannan antigen (GM) testing combined with chest computed tomography (CT) as a noninvasive method for early diagnosis of invasive pulmonary aspergillosis (IPA) in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment. Methods We retrospectively analyzed the data of 376 patients with febrile neutropenia from January 2015 to August 2017. All patients were given broad-spectrum antibiotics and divided into the control group (effective antibiotic treatment, no antifungal drugs given) and the observational group (ineffective antibiotic treatment, antifungal drugs given). The serum GM testing, chest CT, and microbiological examination findings were compared between the two groups. Results The false-positive rates of GM testing for IPA in the control and observational groups were 4.04% and 8.65%, respectively, and the false-negative rates in the two groups were 1.10% and 9.62%, respectively. Sixty-five patients in the observational group and 11 in the control group had typical features of CT imaging. Conclusion Clinical weekly screening of serum GM and chest CT may be an effective combined approach to the early diagnosis of IPA in patients with febrile neutropenia, even if they have undergone antifungal treatment.

scholarly journals Bronchoalveolar galactomannan in invasive pulmonary aspergillosis: a prospective study in pediatric patients

2015 ◽  
Vol 53 (7) ◽  
pp. 709-716 ◽  
Author(s):  
Shilan Mohammadi ◽  
Soheila Khalilzadeh ◽  
Koroush Goudarzipour ◽  
Maryam Hassanzad ◽  
Alireza Mahdaviani ◽  
...  
Keyword(s):  
Prospective Study ◽  
Pediatric Patients ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
A Prospective Study

scholarly journals The strategy for the diagnosis of invasive pulmonary aspergillosis should depend on both the underlying condition and the leukocyte count of patients with hematologic malignancies

Blood ◽  
2012 ◽  
Vol 119 (8) ◽  
pp. 1831-1837 ◽  
Author(s):  
Anne Bergeron ◽  
Raphaël Porcher ◽  
Annie Sulahian ◽  
Cédric de Bazelaire ◽  
Karine Chagnon ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Invasive Pulmonary Aspergillosis ◽  
Diagnostic Strategy ◽  
Cell Transplant ◽  
Pulmonary Aspergillosis ◽  
Hematopoietic Stem ◽  
Underlying Condition ◽  
Leukocyte Counts

Abstract The identification of the causative organism in invasive pulmonary aspergillosis (IPA) is recommended. We investigated whether a mycologic diagnostic strategy could be optimized based on patient characteristics. Fifty-five patients were enrolled in a prospective study. The presence of Aspergillus in respiratory samples occurred more frequently in non-acute leukemia (AL) patients than in AL patients (P = .0003), and in patients with leukocyte counts more than 100/mm3 (P = .002). In a logistic regression model, these 2 factors appeared to be independent, with an adjusted odds ratio of 7.14 (95% confidence interval, 1.40-36.5) for non-AL patients and an adjusted odds ratio of 6.97 (95% confidence interval, 1.33-36.5) for patients with leukocyte counts more than 100/mm3. A positive mycologic result was also more frequent among patients with lung CT scan signs of airway-invasive disease than among other patients (P = .043). Airway-invasive signs were more frequent among non-AL patients (P = .049), whereas angioinvasive disease was more frequent among both AL patients (P = .01) and patients with leukocyte counts less than 100/mm3 (P = .001). A concomitant pulmonary infection was identified more frequently among non-AL patients (P = .005 vs allogeneic hematopoietic stem cell transplant and P = .048 vs others). Our results suggest that different strategies for diagnosing IPA should be considered based on the underlying condition.

Invasive pulmonale Aspergillose

2019 ◽  
Vol 144 (17) ◽  
pp. 1218-1222
Author(s):  
Hanna Matthews ◽  
Holger Rohde ◽  
Dominic Wichmann ◽  
Stefan Kluge
Keyword(s):  
Influenza Infection ◽  
Invasive Pulmonary Aspergillosis ◽  
Organ Transplant ◽  
Severe Neutropenia ◽  
Solid Organ ◽  
First Line ◽  
Pulmonary Aspergillosis ◽  
Hematopoietic Stem ◽  
Severe Influenza ◽  
Life Threatening

AbstractInvasive pulmonary aspergillosis is a life-threatening disease occurring in patients with severe immunosuppression. It is classically associated with severe neutropenia following hematopoietic stem cell transplantation, but other risk factors include COPD, corticosteroid therapy, solid organ transplant, liver failure and preceding severe influenza infection. Due to the high mortality of the disease, rapid diagnosis and treatment are crucial. Diagnosis is based on CT scan and bronchoscopy including microscopy, culture and galactomannan detection in BAL. Histopathology remains the gold standard diagnosis but is not feasible in many cases. First line treatment is voriconazole, new recommendations also support the triazole isavuconazole.

Bronchoalveolar galactomannan in invasive pulmonary aspergillosis: A prospective study in pediatric patients

2015 ◽  
Author(s):  
Shilan Mohammadi ◽  
Soheila Khalilzadeh ◽  
Koroush Goudarzipour ◽  
Maryam Hassanzad ◽  
Alireza Mahdaviani ◽  
...  
Keyword(s):  
Prospective Study ◽  
Pediatric Patients ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
A Prospective Study
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