Abstract
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.
Highlights
Aspergillus is a ubiquitous fungus which can cause various kinds of pulmonary aspergillosis, such as allergic bronchopulmonary aspergillosis (ABPA), pulmonary aspergilloma (PA), and invasive pulmonary aspergillosis [1] (IPA)
183 patients participated in our final analysis (Figure 1)
IPA patients were classified as proven IPA (n = 0), probable IPA (n = 10), and possible IPA (n = 21)
Summary
Aspergillus is a ubiquitous fungus which can cause various kinds of pulmonary aspergillosis, such as allergic bronchopulmonary aspergillosis (ABPA), pulmonary aspergilloma (PA), and invasive pulmonary aspergillosis [1] (IPA). IPA is the most severe type in the pulmonary aspergillosis. It is an important cause of fatality in immunocompromised populations, especially in hematological and solidorgan transplant patients [2]. Once a study reported that the morbidity of IPA might be 15% to 20% in HSCT recipients and neutropenic patients with hematologic malignancies, and the mortality can be as high as 50% to 90% [3]. We evaluated the utility of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) in nonneutropenic patients. In our case-control analysis, nine patients with false-positive results received treatment with Piperacillin/tazobactam, there was no significant difference between case and control group. Our retrospective study suggests that the optimal value of GM detection in BALF is 0.76 in nonneutropenic patients
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