Usefulness of galactomannan detection in the diagnosis and follow-up of hematological patients with invasive aspergillosis
MD Moragues, E Amutio, JC GarcÃa-Ruiz, J PontÃ³n
Date: 4 April 2004
The usefulness of galactomannan detection using the PlateliaÂ®Aspergillus testfor the diagnosis of invasive aspergillosis was studied in 849 sera from 54 hematologicalpatients with prolonged neutropenia, which were classified according tothe risk for invasive aspergillosis. Three patients developed a proven invasiveaspergillosis, one a probable invasive aspergillosis and 17 patients a possibleinvasive aspergillosis. Thirty-three patients showed no evidence of invasiveaspergillosis. All patients with proven invasive aspergillosis had a high risk forinvasive aspergillosis, while the one having probable invasive aspergillosis hadintermediate risk. Detection of galactomannan in this study showed a sensitivityof 66.7% for patients with proven invasive aspergillosis and 50% for patients withproven and probable invasive aspergillosis. The specificity was 98% or higher in all groups studied. The predictive positive and negative values for patients withproven invasive aspergillosis were 66.7% and 98%, respectively. A rise in theconcentration of galactomannan was observed in patients who failed to respondto the antifungal treatment. Galactomannan antigenemia preceded post-mortemhistological diagnosis of invasive aspergillosis in two patients by 17 and 81 days,respectively. In conclusion, detection of galactomannan by thePlateliaÂ®Aspergillus test allows for a specific and relatively sensitive diagnosis ofinvasive aspergillosis in hematological patients with a high and intermediate riskfor invasive aspergillosis.
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