关键词: Galactomannan antigen testing antifungal treatment computed tomography febrile neutropenia hematological malignancies invasive pulmonary aspergillosis

Mesh : Adolescent Adult Aged Antifungal Agents / adverse effects Aspergillus / isolation & purification Early Diagnosis Febrile Neutropenia / drug therapy etiology Female Follow-Up Studies Galactose / analogs & derivatives Hematologic Neoplasms / complications Humans Invasive Pulmonary Aspergillosis / chemically induced diagnosis metabolism Male Mannans / blood Middle Aged Prognosis Retrospective Studies Tomography, X-Ray Computed / methods Young Adult

来  源:   DOI:10.1177/0300060518811472   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
OBJECTIVE: To investigate the value of serum galactomannan antigen (GM) testing combined with chest computed tomography (CT) as a noninvasive method for early diagnosis of invasive pulmonary aspergillosis (IPA) in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment.
METHODS: We retrospectively analyzed the data of 376 patients with febrile neutropenia from January 2015 to August 2017. All patients were given broad-spectrum antibiotics and divided into the control group (effective antibiotic treatment, no antifungal drugs given) and the observational group (ineffective antibiotic treatment, antifungal drugs given). The serum GM testing, chest CT, and microbiological examination findings were compared between the two groups.
RESULTS: The false-positive rates of GM testing for IPA in the control and observational groups were 4.04% and 8.65%, respectively, and the false-negative rates in the two groups were 1.10% and 9.62%, respectively. Sixty-five patients in the observational group and 11 in the control group had typical features of CT imaging.
CONCLUSIONS: Clinical weekly screening of serum GM and chest CT may be an effective combined approach to the early diagnosis of IPA in patients with febrile neutropenia, even if they have undergone antifungal treatment.
摘要:
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