Galactomannan as a Diagnostic Test for Invasive Pulmonary Aspergillosis in a Patient with Primary Immunodeficiency: Case Report

Abstract

Introduction: Aspergillosis continues to be the most frequent fungal infection in the hematopoietic stem cell transplanted patient, however, in other types of immunocompromised states, such as primary immunodeficiencies, are scarce. Therefore, many times the diagnosis of invasive aspergillosis is often a diagnostic challenge for the clinician, so we highlight the usefulness of galactomannan in immunocompromised patients for the diagnosis of aspergillosis. Background: Invasive aspergillosis together with chronic pulmonary aspergillosis and allergic bronchopulmonary aspergillosis, constitute the clinical forms of aspergillosis. Aspergillus fumigatus-complex is the most frequent etiological agent, the increase in immunosuppressive treatments and the greater use of corticoids have led to a greater prominence of aspergillosis in recent years. The use of galactomannan and imaging tests complement the microbiological limitations in the diagnosis of these patients, the mortality of invasive forms depends on the clinical form and the type of host. Objective: To demonstrate the importance of galactomannan as a noninvasive diagnostic test for invasive pulmonary aspergillosis, in centers with limited resources where it is not possible to perform a histopathological study. Case presentation: We present the case of an 18-year-old male patient with immunodeficiency due to T lymphocyte immunoregulation dysfunction, who developed invasive pulmonary aspergillosis with a positive galactomannan test. Conclusions: Our case report reflects the diagnosis of ante-mortem invasive pulmonary aspergillosis in an adult patient with primary T-lymphocyte immunodeficiency, non-neutropenic, in whom a histopathological study to optimize the diagnosis was not possible, and whose only tool we had was the measurement of GM. Abbreviations: GM= Galactomannan