Objectives: Invasive fungal infections play an important role as severe infection, constantly rising in the services in charge of patients at risk. Diagnosis and treatment are difficult because of the absence of pathognomonic signs and symptoms. The delay in diagnosis leads to delayed treatment and thus worsened prognosis The objective of this study is to identify the place of laboratory tools applied in the diagnosis of deep candidiasis, Cryptococcosis, Pneumocystosis and invasive aspergillosis.
Methods: This is a descriptive prospective study spanning 07 years (2010-2016) and having respective 998 samples from patients from several medical services: intensive care, Internal Medicine, major burned, Onco-Hematology, infectious diseases, Cardiology, Gastroenterology, Nephrology and Pediatrics. The seach of the mannan antigen for the diagnosis of invasive candidiasis and galactomannan antigen for the diagnosis of invasive aspergillosis occurs by Enzyme Linked ImmunoSorbent Assay . The search for the capsular antigen of Cryptococcus held by slide agglutination and Pneumocystis spp. by DFA. The search for antibody anti-Candida and antiAspergillus occurs by Enzyme Linked ImmunoSorbent Assay. Blood cultures and device samples are also studied for these patients.
Results: Among the 371 sera studied for suspected invasive candidiasis, 53 were positive (14.28%) and among 286 sera investigated for suspected invasive aspergillosis, 22 were positive (7.69%). Four cases of Cryptococcosis were confirmed and three cases of Pneumocystosis. Specie isolated from Blood cultures, device and peripheral samples were 93 % C. albicans , 1,5 % were other species : C. parapsilosis, C.zeylanoides, C. glabrata, C.krusei.
Conclusion: Invasive fungal infections remain under-diagnosed clinically and therefore mycologically. The mycological diagnosis associated with sero-immunological diagnosis is a decisive contribution in these conditions. A delay in diagnosis worsens the prognosis of these violations where the interests of a multidisciplinary proper care.
Full conference title:
- TIMM (2019)