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Galactomannan-Based and PCR-Based Assays in Bronchoalveolar Lavage to Diagnose Invasive Aspergillosis: Current Status and Future Prospects

  • Advances in Diagnosis of Invasive Fungal Infections (U Binder, Section Editor)
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Abstract

Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in patients receiving chemotherapy or undergoing allogeneic haematopoietic stem cell transplantation for acute leukemia. The existing tools to diagnose IPA lack specificity or sensitivity, or both; the search for improved diagnostic tools for IPA has focused on novel serologic and molecular methods. Aspergillus Galactomannan enzyme-linked immunosorbent assay (GM) analyses showed sensitivity rates in serum samples ranging in a wide span; testing GM in bronchoalveolar lavage (BAL) originated from the primary site of the infection seems to be more sensitive in patients with IPA. Other novel diagnostic markers to detect fungal DNA directly in clinical samples, rapidly, early, sensitively and specifically, are provided by polymerase chain reaction (PCR) based assays; higher sensitivity and specificity rates have been observed for BAL samples in IPA, even under antifungal treatment. The clinical place value of a diagnostic approach combining PCR and GM in BAL is unclear.

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Dieter Buchheidt declares that he has no conflict of interest.

Birgit Spiess declares that she has no conflict of interest.

Wolf-Karsten Hofmann declares that he has no conflict of interest.

Mark Reinwald has received grants from Pfizer GmbH and Gilead Sciences, and has received support for travel to meetings for study or other purposes from Astellas Pharma, Celgene GmbH and Novartis GmbH.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Department of Hematology and Oncology, Mannheim University Hospital, University of Heidelberg, Theodor-Kutzer-Ufer 1 – 3, 68167, Mannheim, Germany

    Dieter Buchheidt, Birgit Spiess, Wolf-Karsten Hofmann & Mark Reinwald

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  1. Dieter Buchheidt
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Buchheidt, D., Spiess, B., Hofmann, WK. et al. Galactomannan-Based and PCR-Based Assays in Bronchoalveolar Lavage to Diagnose Invasive Aspergillosis: Current Status and Future Prospects. Curr Fungal Infect Rep 7, 273–282 (2013). https://doi.org/10.1007/s12281-013-0141-2

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