Original Paper

Mycopathologia

, Volume 163, Issue 4, pp 191-202

First online:

Update on the contribution of galactomannan for the diagnosis of invasive aspergillosis

  • Valério R. AquinoAffiliated withMycology Laboratory, Service of Clinical Pathology, Hospital de Clínicas de Porto Alegre
  • , Luciano Z. GoldaniAffiliated withDepartment of Internal Medicine, Universidade Federal do Rio Grande do Sul
  • , Alesssandro C. PasqualottoAffiliated withSchool of Medicine, The University of Manchester Email author 

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Abstract

The diagnosis of invasive fungal infections (IFI) remains a challenge, particularly for diseases caused by filamentous fungi such as Aspergillus species. Unfortunately, many patients affected by these conditions are not identified before autopsy. Therefore, there is a need for new diagnostic methods for IFI. Galactomannan is a soluble antigen released during hyphal growth in tissues. A commercially available sandwich ELISA assay that detects galactomannan has been used in Europe for many years and is now approved for use in the USA. The test has an excellent negative predictive value in the detection of invasive aspergillosis (IA) in high-risk patients. In addition, it is more sensitive than culture and allows IA to be diagnosed before clinical manifestations occur. However, false-negative and false-positive results in certain populations are the main limitations to its use. The purpose of this review is to summarize the current knowledge about galactomannan testing in patients at risk for IA.

Keywords

Aspergillosis Bone marrow transplantation Galactomannan Invasive fungal infections Solid organ transplantation