Diagnosis of Invasive Septate Mold Infections

Abstract

We correlated results of microbiologic culture and histopathologic examination for 2,891 consecutive samples from autopsy tissue, surgical or biopsy tissue, and bronchoalveolar lavage (BAL) or bronchial washing (BW) specimens. For 23 autopsy cases with suspected invasive septate mold infections by histopathologic examination, culture yielded a mold in 12 cases (52%). For 1,683 surgical or biopsy samples, histopathologic evidence of invasive septate mold infection was present in 30 samples, 9 of which also grew mold by culture (30%); 20 additional samples grew mold in culture alone, possibly representing culture contamination. Of 1,185 BAL and BW samples, mold was evident in 28 by cytologic examination and culture, 20 by cytologic examination alone, and 68 by culture alone. These results suggest a positive concordance for culture and histologic-cytologic examination of 23%, although both methods were negative in 96% of surgical and biopsy tissue and BAL and BW samples. The septate molds cultured from these samples were Aspergillus fumigatus (19), Aspergillus flavus (15), Aspergillus terreus (13), Aspergillus niger (7), Fusarium species (3), and Scedosporium apiospermum (2). A flavus was isolated significantly more frequently from tissue than from BAL and BW samples.

Invasive pulmonary aspergillosis with spontaneous resolution and the diagnostic utility of PCR from tissue specimens

“…may be as low as 50%. 6 In this situation it seems reasonable that other tests which provide genus specific information such as PCR, galactomannan and potentially even antibody detection or immunohistochemistry could be used in a similar manner. The EORTC/MSG criteria state that an invasive mould infection should be annotated with the relevant genus if such information is available, although non-culture tests have not been specifically explored or evaluated in this context.…”

Antifungal therapy and surgical drainage for the treatment of a cerebral abscess caused by Scedosporium apiospermum in a renal transplant patient - a case report

“…The diagnosis of an invasive fungal infection such as S. apiospermum is based on the combination of histopathological, microbiological and clinical findings 14 . As the clinical and histopathological presentations of S. apiospermum infections are similar to those of other fungi such as Aspergillus and Fusarium spp., a culture is necessary for accurate diagnosis.…”

Development of an HPTLC‐based diagnostic method for invasive aspergillosis

“…An initial accurate, rapid diagnosis of IA is important for various clinical reasons. Recently diff erent diagnostic tools have been used such as direct fungal staining, fl uoresescent techniques and fungal culturing, enabling rapid and accurate diagnosis (Tarrand et al, 2003). Analysis of galactomanan and (1,3)-β-D-glucan as diagnostic markers for specifi c diagnostics of IA is not straightforward, because galactomanan is also found in the cell walls of most Penicillium species and (1,3)-β-D-glucan is found in fungal species other then Aspergillus spp.…”