Author:

C Pazos, A del Palacio

Date: 4 April 2004

Abstract:

The diagnosis of invasive aspergillosis in neutropenic individuals is difficult andlengthy since non-invasive diagnostic tests lack sensitivity and specifity. Thediagnosis of invasive aspergillosis in 154 prolonged neutropenic patients wasprospectively bi-weekly validated by screening circulating galactomannan. Theglobal sensitivity was 73% and specificity was 96%. The positive and negativepredictive values were 73% and 98% respectively. False positive reactions occurredat a rate of 2%. Antigenemia was detected before clinical suspicion of invasiveaspergillosis (median, 6 days before) in 30% of patients and anticipated theonset of radiologic signs 9 days in 60% of patients. Conclusion: the prospectivescreening of galactomannan is a sensitive and non-invasive tool for early diagnosisof invasive aspergillosis in high-risk adult hematology patients.

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