Early diagnosis of central nervous system aspergillosis using polymerase chain reaction, latex agglutination test, and enzyme‐linked immunosorbent assay

Kami, Masahiro; Ogawa, Seishi; Kanda, Yoshinobu; Tanaka, Yuji; Machida, Utako; Matsumura, Tomoko; Sakamaki, Hisashi; Hirai, Hisamaru

doi:10.1046/j.1365-2141.1999.01542.x

Cited by 69 publications

(55 citation statements)

References 5 publications

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“…Recently, detection of Aspergillus antigen or DNA in CSF has been suggested to be useful in the diagnosis of CNS aspergillosis. 22 A definitive diagnosis of CNS aspergillosis requires histopathological samples, that can be obtained only by neurosurgery. These procedures are often not practical in this setting and may unnecessarily delay the start of therapy.…”

Section: Discussionmentioning

confidence: 99%

Central nervous system aspergillosis in allogeneic stem cell transplant recipients

Jantunen

Volin

Salonen

et al. 2003

Bone Marrow Transplant

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Summary:Invasive aspergillosis (IA) is relatively common in allogeneic stem cell transplant (SCT) recipients. Although lungs are the most common site, central nervous system (CNS) involvement is also observed in this setting. We have retrospectively studied 14 cases of CNS aspergillosis found in a cohort of 455 allogeneic SCT recipients (incidence 3%). All patients, except one, had experienced acute graft-versus-host disease treated with high-dose methylprednisolone, and eight patients (57%) had also received ATG. The median time to the diagnosis of CNS aspergillosis was 124 days (range 49-347 days) from SCT. Pulmonary aspergillosis had been diagnosed earlier in four patients (29%). The most common initial symptoms of CNS aspergillosis were convulsions, hemiparesis, and mental alteration. Neuroradiological studies revealed single (two patients) or multiple (seven patients) focal lesions of 0.2-9 cm in diameter. Despite clinical suspicion in many patients, a confirmed diagnosis of CNS aspergillosis was made during life in only one patient. A total of 12 patients (86%) received amphotericin B. Despite therapy, all patients died 0-27 days (median seven days) after the initial CNS symptoms. CNS aspergillosis is not uncommon in allogeneic SCT recipients. Clinical manifestations are usually dramatic and progress quickly. Earlier and more effective treatment of IA is needed to prevent dissemination of infection into the CNS.

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Section: Discussionmentioning

confidence: 99%

Central nervous system aspergillosis in allogeneic stem cell transplant recipients

Jantunen

Volin

Salonen

et al. 2003

Bone Marrow Transplant

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“…Several studies have demonstrated recently that Aspergillus DNA can be detected successfully in various samples by different PCR-assays 7,[9][10][11][12][13][14] . We have evaluated the specificity of determination, sensitivity, repeability Detection of Aspergillus spp.…”

Section: Discussionmentioning

confidence: 99%

Detection of Aspergillus Spp. In Biological Samples by Real-Time PCR

Bolehovská¹,

Plíšková²,

Buchta³

et al. 2006

BIOMED PAP

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Background:Recently, the proportion of invasive infections caused by the filamentous fungi of the Aspergillus genus are growing in immunocompromised persons particularly in transplant recipients and neutropenic patients. Unfortunately, laboratory diagnostics of invasive aspergillosis remains extremely difficult, mainly with regard to the sensitivity of the methods and to the correct interpretation of the results in particular.Aim: The aim of this work was to design a standard and reproducible Aspergillus DNA detection method and its validation. The second aim was to practically use this method for diagnosis of Aspergillus DNA in various samples in patients.Method: Real-time PCR with two hybridization probes. Amplification and on-line quantification was carried out on a LightCycler ® 1.5 Instrument. Results: Specificity of the reaction was tested for A. fumigatus, A. flavus, A. niger and A. terreus, and its sensitivity was determined at 5 copies per ml. The reproducibility of the results was comparable to other methods, reported in the literature.Applicability of the real-time PCR was assessed for detection of Aspergillus DNA in 354 various clinical samples taken from 179 patients at risk of invasive aspergillosis over the period of 33 months. Of 354 samples 103 (29.10 %) taken from 65 patients (36.31 %) were evaluated as positive. Over one year, the percentage of positive samples was mostly about 30 % or less per month.Conclusions: Our results demonstrate the high sensitivity, specificity and reproducibility of this technique, and its usefulness for rapid laboratory diagnosis of invasive aspergillosis.

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“…69 Culture of CSF infrequently yields positive results, 94,114 and both chemical findings in the CSF and the CT results are often non-specific. [115][116][117] Galactomannan may also be detected in the CSF, with a sensitivity and specificity of 80% and 100%, respectively, according to a study involving only five patients with proven CNS aspergillosis. 117 Galactomannan has been detected in other clinical specimens as well.…”

Section: N E W D I a G N O S T I C T O O L Smentioning

confidence: 99%

“…[115][116][117] Galactomannan may also be detected in the CSF, with a sensitivity and specificity of 80% and 100%, respectively, according to a study involving only five patients with proven CNS aspergillosis. 117 Galactomannan has been detected in other clinical specimens as well. 69 …”

Section: N E W D I a G N O S T I C T O O L Smentioning

confidence: 99%

Diagnosis of Invasive Fungal Infections – Current Limitations of Classical and New Diagnostic Methods

Pasqualotto¹,

Denning²

2005

European Oncology &Amp; Haematology

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Early diagnosis of central nervous system aspergillosis using polymerase chain reaction, latex agglutination test, and enzyme‐linked immunosorbent assay

Cited by 69 publications

References 5 publications

Central nervous system aspergillosis in allogeneic stem cell transplant recipients

Central nervous system aspergillosis in allogeneic stem cell transplant recipients

Detection of Aspergillus Spp. In Biological Samples by Real-Time PCR

Diagnosis of Invasive Fungal Infections – Current Limitations of Classical and New Diagnostic Methods

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