Serum antigens assay combined with chest CT scan in diagnosis of invasive pulmonary aspergillosis

Abstract

To evaluate serum antigens assay combined with chest CT scan in the diagnosis of patients of invasive pulmonary aspergillosis (IPA) without neutropenia. One hundred and thirteen patients with suspected IPA admitted in Department of Respiratory Medicine, Infectious Diseased, Kidney Disease Centre and ICU were included in the study. Serum levels of 1-3-β-D-glucan (G) antigen and galactomannan antigen (GM) were assayed and chest CT scans were performed in all cases. Clinically invasive pulmonary aspergillosis was defined as proven, probable and possible. Treatment effectiveness was recorded. In this series 4 proven IPA, 36 probable IPA, 16 possible IPA, and 57 non-aspergillosis infection were diagnosed. GM test was more sensitive than G test. The specificity of two serum test was 84.2% and 87.7%, respectively. The sensitivity of chest CT was 30.0 %. The specificity of GM assay combined with chest CT was 100.0 %, while the sensitivity was 47.5%. The GM assay combined with chest CT may increase the specificity of diagnosis for IPA patients without neutropenia.