613. Serum and Bronchoalveolar Lavage Fluid (BAL) Galactomannan (GM) Assays in Patients with Pulmonary Aspergilloma (PA)
Session: Abstracts: Mycology
Friday, October 22, 2010
Background: Although the diagnostic role of GM assay has been well known in patients with invasive pulmonary aspergillosis, there are limited data about the utility of GM assay in patients with PA. We therefore evaluated clinical utility of serum and BAL GM assay in patients with PA.

Methods: We reviewed the medical records of patients with suspected PA for whom serum or BAL GM assay was performed at the Asan Medical Center (Seoul, South Korea) over a two-year period. We enrolled all patients who were diagnosed with PA who performed serum or BAL GM assays. PA is defined as a mobile mass lesion within a preexisting pulmonary cavity visualized on a chest X- ray or computed tomography scan. Proven PA was classified as microscopic demonstration in histologic specimens and/or isolation in culture of Aspergillus spp. from the sputum, BAL fluid or sterile material. In the absence of Aspergillus spp. upon culture or microscopic demonstration in histologic specimen, the diagnosis was classified as probable PA.

Results: A total 48 patients with PA were included in this study. Of these 48 patients, 38 (79%) were classified as proven PA and 10 (21%) as probable PA. Among the 34 (71%) patients who underwent serum GM assay, the sensitivity of serum GM assay was 38% (13/34, 95% CI 22–56). The positivity of serum GM assay was significantly frequent in patients with hemoptysis than in patients without hemoptysis (52% vs. 9%, p = 0.02). Among the 36 (75%) patients who underwent BAL GM assay, the sensitivity of BAL GM assay was 92% (33/36, 95% CI 78–98).

Conclusion: Our study suggests that serum GM assay may be positive even in patients with non-invasive form aspergillosis such as PA, especially in those with hemoptysis. Our data also suggest that BAL GM assay may retain high positive in patients with non-invasive form aspergillosis such as PA.


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Seong Yeon Park, MD , Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Song Mi Moon, MD , Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Ki-Ho Park, MD , Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Oh-Hyun Cho, MD , Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Yong Pil Chong, MD , Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Sang-Ho Choi, MD , Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
June Hee Woo, MD , Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Yang Soo Kim, MD , Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Sung-Han Kim, MD , Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Disclosures:

S. Y. Park, None

S. M. Moon, None

K. H. Park, None

O. H. Cho, None

Y. P. Chong, None

S. H. Choi, None

J. H. Woo, None

Y. S. Kim, None

S. H. Kim, None

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