Faculty Opinions recommendation of Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases.

Background. We evaluated the utility of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) in nonneutropenic patients. Methods. A total of 183 patients were included in the final analysis. Bronchoscopies and the detection of GM in BALF were all performed on them. Results. Ten cases of IPA were diagnosed. ROC data demonstrated that, for diagnosing IPA, an optimal cutoff value for GM in BALF of 0.76 yielded a sensitivity of 100.0% and a specificity of 76.2%. Symptoms and radiological findings had no significant difference between proven or probable IPA group and non-IPA group. In our case-control analysis, although nine patients with false-positive results received treatment with Piperacillin/tazobactam, there was no significant difference between case and control group. Conclusions. BALF GM detection is a valuable adjunctive diagnostic tool. Our retrospective study suggests that the optimal value of GM detection in BALF is 0.76 in nonneutropenic patients.

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Evaluation of Aspergillus-Specific Lateral-Flow Device Test Using Serum and Bronchoalveolar Lavage Fluid for Diagnosis of Chronic Pulmonary Aspergillosis

Journal of Clinical Microbiology ◽

10.1128/jcm.00095-19 ◽

2019 ◽

Vol 57 (5) ◽

Cited By ~ 3

Author(s):

Takahiro Takazono ◽

Yuya Ito ◽

Masato Tashiro ◽

Keitaro Nishimura ◽

Tomomi Saijo ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Point Of Care ◽

Invasive Pulmonary Aspergillosis ◽

Antibody Test ◽

Lavage Fluid ◽

Serum Samples ◽

Pulmonary Aspergillosis ◽

Flow Device ◽

Chronic Pulmonary Aspergillosis

ABSTRACT The Aspergillus-specific lateral-flow device (AspLFD) test is a newly developed point-of-care diagnostic method for invasive pulmonary aspergillosis. However, evidence of the diagnostic performance of the AspLFD for chronic pulmonary aspergillosis (CPA) is limited. Therefore, we conducted a retrospective study to investigate this in comparison with the galactomannan (GM) β-d-glucan (BDG) test. Fifty patients with chronic pulmonary aspergillosis and 65 patients with respiratory disease, as a control, were enrolled in this study. The majority of the CPA disease entities were chronic pulmonary aspergillosis (64.0%, n = 32), followed by subacute invasive pulmonary aspergillosis (IPA) (20.0%, n = 10) and simple pulmonary aspergilloma (SPA) (16.0%, n = 8). The sensitivity and specificity of the AspLFD test in serum samples were 62.0% and 67.7%, respectively. The GM test (cutoff index, 1.54) showed a sensitivity of 22% and a specificity of 92.3%, while the sensitivity and specificity of the BDG test (cutoff, 19.3 pg/ml) were 48% and 90.8%, respectively. In bronchoalveolar lavage fluid samples, the AspLFD test showed a sensitivity of 66.7% and a specificity of 69.2%, while those of the GM test (cutoff index, 0.6) were 72.7% and 83.1%, respectively. The Aspergillus precipitating antibody test had 70% sensitivity. Unlike the Aspergillus precipitating antibody test, the AspLFD on serum samples showed similar sensitivity to non-fumigatus Aspergillus species. Patients with false-positive results for the AspLFD on serum samples were of a significantly higher age and had a higher prevalence of cavitary lesions in chest computed tomography than patients with negative results in the control group. Given the results in this study, the performance of the AspLFD using serum was acceptable as a point-of-care test for the diagnosis of CPA.

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The predictive value ofAspergillusPCR testing on bronchoalveolar lavage fluid for early diagnosis of invasive pulmonary aspergillosis in hematologic patients

Leukemia & Lymphoma ◽

10.1080/10428194.2017.1315116 ◽

2017 ◽

Vol 58 (12) ◽

pp. 2943-2946 ◽

Cited By ~ 6

Author(s):

Francesco Marchesi ◽

Antonio Spadea ◽

Fulvia Pimpinelli ◽

Grazia Prignano ◽

Maria Grazia Paglia ◽

...

Keyword(s):

Early Diagnosis ◽

Bronchoalveolar Lavage ◽

Predictive Value ◽

Bronchoalveolar Lavage Fluid ◽

Invasive Pulmonary Aspergillosis ◽

Lavage Fluid ◽

Pulmonary Aspergillosis

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"Pathogenic Microorganism Detection in Invasive Pulmonary Aspergillosis(IPA) Patients Using Bronchoalveolar Lavage Fluid"

Biomedical Journal of Scientific & Technical Research ◽

10.26717/bjstr.2021.38.006130 ◽

2021 ◽

Vol 38 (2) ◽

Author(s):

Chang-ran Zhang

Keyword(s):

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Invasive Pulmonary Aspergillosis ◽

Lavage Fluid ◽

Pathogenic Microorganism ◽

Pulmonary Aspergillosis

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Galactomannan and 1, 3-β-D-Glucan Assay in Bronchoalveolar Lavage Fluid for the Diagnosis of Invasive Pulmonary Aspergillosis in Malignant and Non-malignant Patients

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5994 ◽

2021 ◽

Vol 9 (A) ◽

pp. 362-366

Author(s):

Hadir Ahmed El-Mahallawy ◽

Rana El-Gendi ◽

Doaa Mohammad Ghaith ◽

Iman Kamal Behiry ◽

Soheir Fathy Helal

Keyword(s):

Bronchoalveolar Lavage ◽

Fungal Infection ◽

Bronchoalveolar Lavage Fluid ◽

Fungal Infections ◽

Invasive Pulmonary Aspergillosis ◽

Lavage Fluid ◽

Pulmonary Aspergillosis ◽

Predictive Values ◽

Sensitivity Specificity ◽

Rule Out

BACKGROUND: Serum 1, 3-β-D-glucan (BDG) assay was recommended for diagnosing fungal infections. AIM: We aimed to assess 1, 3-β-D-glucan in bronchoalveolar lavage (BAL) fluid in invasive pulmonary aspergillosis (IPA). METHODS: Out of 104 patients clinically suspected fungal, 45 were probable, 18 possible, and 41 unlikely according to EORTC/MSG 2008 criteria. Measuring BAL BDG and galactomannan were done. RESULTS: The sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for BDG were 44%, 71%, 62%, and 54%; for galactomannan 84%, 83%, 84%, and 83%; and 93%, 66%, 75%, and 90%, respectively, when combining both tests. A significant different performance of GM; p = 0.0008 was detected in patients with malignant disorders when compared to non-malignant; but not for BDG; p = 0.121. CONCLUSION: We can conclude that BAL-BDG is helpful if positive in a clinically suspected IFI case, but if negative cannot rule out fungal infection. Thus, combining results of BAL-GM and BAL-BDG are recommended.

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