Author/Authors :
Salehi ، Mohammadreza Department of Infectious Diseases and Tropical Medicines - School of Medicine, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Hashemi ، Jamal Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , Khodavaisy ، Sadegh Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , Emami ، Amir Hossein Adult Hematology and Oncology Ward, Department of Internal Medicine - Cancer Institute, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , SafaeeNodehi ، Reza Adult Hematology and Oncology Ward, Department of Internal Medicine - Cancer Institute, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Rasolinezhad ، Mehrnaz Department of Infectious Diseases and Tropical Medicines - School of Medicine, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Ahmadikia ، Kazem Department of Medical Parasitology and Mycology - School of Public Health - Tehran University of Medical Sciences , DehghanManshadi ، Ali Department of Infectious Diseases and Tropical Medicines - School of Medicine, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Abdollahi ، Alireza Department of Pathology - School of Medicine, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences , Amali ، Amin Department of Otorhinolaryngology - School of Medicine, Otorhinolaryngology Research Center - Tehran University of Medical Sciences , Mokhtarian ، Maryam Department of Infectious Diseases and Tropical Medicines - School of Medicine, Imam Khomeini Hospital Complex - Tehran University of Medical Sciences
Abstract :
Background: Invasive aspergillosis (IA) is the most prevalent invasive infection with high mortality among patients with leukemia. Early diagnosis of IA has been a challenging topic in this group of patients. Objectives: In this study, we evaluated the galactomannan levels of nasal lavage fluid (NALF) as a possible auxiliary method for IA diagnosis in patients with leukemia. Methods: In a prospective study, 32 adult patients with leukemia who were taking induction and/or consolidation chemotherapy with fever and neutropenia were included. In all patients, galactomannan (GM) levels of serum and NALF, and mycological examinations were evaluated before the first dose of antifungal therapy. Results: Fourteen (43.7%) patients had NALF GM ≥ 0.5; however, in 16 (50%) patients the level of serum GM was ≥ 0.5. The elevated level of NALF GM had a significant association with the proven IA cases (P = 0.048). The GM level of NALF with a cut-off value of 0.45 (by receiver operating characteristic curve analysis) had 78% sensitivity and 64% specificity for the diagnosis of invasive aspergillosis (P = 0.033). Conclusions: Due to its non-invasive nature, GM level of NALF may be contributory to be used as part of the diagnostic work‐up of IA particularly in leukemic patients with thrombocytopenia which prohibits acquiring bronchoalveolar lavage.
Keywords :
Galactomannan , Nasal Lavage Fluid , Aspergillosis , Hematologic Neoplasms , Invasive Fungal Infections
