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Detection of sputum Aspergillus galactomannan for diagnosis of invasive pulmonary aspergillosis in haematological patients

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Abstract

We investigated the diagnostic utility of Aspergillus galactomannan (GM) in sputum for diagnosis of invasive pulmonary aspergillosis (IPA) in haematologic patients and compared the results with those of bronchial lavage fluid (BLF) and serum. Patients were classified into 4 groups using modified European Organization for Research and Treatment of Cancer criteria: group A, proven IPA; group B, probable IPA; group C, possible IPA; group D, others. Groups A and B were considered the IPA group (n = 6); group D was considered non-IPA group (n = 37); group C (n = 13) was equivocal for IPA. As a true negative control, sputa from patients with community-acquired pneumonia (CAP) without risk factors (group E, n = 22) were used. From the receiver-operating characteristic curves, the cut-off levels were determined as 1.2 in sputum, 0.5–1.3 in BLF and 0.5 in serum. The sensitivity and specificity of sputum, BLF and serum GM were 100 and 62.2%, 66.7 and 100%, and 83.3 and 81.1%, respectively. Twenty-two patients with CAP (group E) showed median GM levels in the sputa of 0.1 (range 0.0–1.0). Sputum GM is a useful non-invasive test for screening of IPA in haematological patients, and may also be useful for assessment of the risk of developing IPA.

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Acknowledgments

We thank Dr. Y. Kaneko, Department of Respiratory Disease, Kameda General Hospital, for his help in this study. We also thank the staffs of central laboratory of Kameda General Hospital.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Kameda General Hospital, 929 Higashi-chou, Kamogawa, Chiba, 296-8602, Japan

    Shun-ichi Kimura, Jun Odawara, Takatoshi Aoki, Masayuki Yamakura, Masami Takeuchi & Kosei Matsue

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  1. Shun-ichi Kimura
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  2. Jun Odawara
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  3. Takatoshi Aoki
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  4. Masayuki Yamakura
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  5. Masami Takeuchi
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  6. Kosei Matsue
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Correspondence to Kosei Matsue.

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Kimura, Si., Odawara, J., Aoki, T. et al. Detection of sputum Aspergillus galactomannan for diagnosis of invasive pulmonary aspergillosis in haematological patients. Int J Hematol 90, 463–470 (2009). https://doi.org/10.1007/s12185-009-0429-8

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  • DOI: https://doi.org/10.1007/s12185-009-0429-8

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