The diagnosis of deep mycoses by morphologic methods

Schwarz, Jan

doi:10.1016/s0046-8177(82)80267-0

Cited by 105 publications

(57 citation statements)

References 13 publications

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“…Documentation of aspergillosis requires the demonstration of acute angle branching septate hyphae invading tissues in biopsy specimens, possibly (but not necessarily) with cultural confirmation. 4,5 However, biopsy is frequently impossible because of the critical condition of the patient and because of severe concomitant thrombocytopenia. Since clinical symptoms and radiological signs are poorly specific, the disease is often suspected and treated empirically.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of an enzyme immunoassay and a latex agglutination system for the diagnosis of invasive aspergillosis in bone marrow transplant recipients

Machetti¹,

Feasi

Mordini

et al. 1998

Bone Marrow Transplant

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Summary:The performance of two Aspergillus antigenemia systems, the sandwich enzyme-linked immunosorbent assay (ELISA), Platelia Aspergillus test, and the latex agglutination (LA), Pastorex Aspergillus test, in the diagnosis of invasive aspergillosis were compared by testing 364 serum samples from 22 bone marrow transplant (BMT) recipients. Sensitivity and specificity for the ELISA test were 60% and 82% respectively, vs 40% and 94% for the LA test. In the two patients found positive with both methods, the ELISA test became positive earlier than the LA test or remained positive after the LA test had become negative. These results encourage further evaluation of the Platelia Aspergillus test, to assess its role in the management of invasive aspergillosis in BMT patients. Keywords: invasive aspergillosis; galactomannan; antigen detectionIn recent years, considerable progress has been achieved in the management of bacterial and viral infections in bone marrow transplant (BMT) recipients. By contrast, little progress has been made in the management of fungal infections, especially aspergillosis. 1 This is probably due both to the frequent impossibility of obtaining a reliable diagnosis of aspergillosis at an early stage of the disease and to the relatively poor efficacy of the presently available antifungal armamentarium. As a result, indirect diagnostic methods have received considerable attention in order to overcome these limitations. So far, no method has proven sufficiently sensitive and specific to allow a diagnosis of aspergillosis at an early stage. 2 However, several authors have pointed out that this might be due, at least in part, to how the tests have been used in clinical practice and to the criteria adopted by clinicians in the interpretation of results. 2 A precommercial version of a sandwich enzymelinked immunosorbent assay (ELISA) for detection of cirCorrespondence: C Viscoli, Unità di Malattie dell'Ospite Compromesso, Istituto Nazionale per la Ricerca sul Cancro-Genova, Largo Rosanna Benzi, 10-16132 Genova, Italy Received 22 May 1997; accepted 17 December 1997 culating galactomannan, a polysaccharide component of the fungal cell wall, has been recently described. 3 The test employs the same monoclonal antibody (MoAb) EB-A2 used in the latex agglutination (LA) test (Pastorex Aspergillus; Sanofi Diagnostic, Pasteur, France), but the ELISA system detects galactomannan in serum at a concentration of 1 ng/ml, whereas the LA test has a 15 ng/ml threshold.We have compared sensitivity and specificity of the new ELISA detection system with that of the LA system in the diagnosis of invasive aspergillosis in BMT patients. With the aim of improving the sensitivity and the specificity of the tests, we prospectively collected consecutive serum samples in patients at high risk of aspergillosis, regardless of the presence or absence of clinical symptoms. Patients and methodsDuring a 6-month period, 22 allogeneic BMTs from matched donors, followed at the Bone Marrow Transplant Unit of the Haematology Department of S...

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Section: Discussionmentioning

confidence: 99%

“…Culture confirmation was not required. 4,5 Serum samples were collected three times per week in the first month after BMT, and once a week in the second and third months. A total of 364 samples were collected and processed following the manufacturer's instructions.…”

Section: Methodsmentioning

confidence: 99%

Comparison of an enzyme immunoassay and a latex agglutination system for the diagnosis of invasive aspergillosis in bone marrow transplant recipients

Machetti¹,

Feasi

Mordini

et al. 1998

Bone Marrow Transplant

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“…Methenamine silver offers the greatest contrast between stained organisms and background material, and thereby is the most sensitive (ref. 23 and Figure 1A). Synovial fluid fungal cultures should be performed to confirm the diagnosis of blastomycosis.…”

Section: Discussionmentioning

confidence: 90%

Blastomycosis presenting as monarticular arthritis. The role of synovial fluid cytology

George

Hays

Graham

1985

Arthritis & Rheumatism

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“…A number of histologic stains are available that are routinely used to visualize fungi in tissue sections. [21,22] While some of these are special fungal stains, others are of more general use and still help to observe the tissue reactions and/or the infecting fungus. GMS, Gridley's fungus and PAS are very efficient to visualize the fungi.…”

Section: Diagnosis Of Fungal Infectionsmentioning

confidence: 99%