关键词: PCR culture fungal diagnosis microscopy molecular-based diagnosis

Mesh : Aspergillus / chemistry cytology genetics isolation & purification Biopsy Bronchoalveolar Lavage Fluid / chemistry microbiology Diagnostic Tests, Routine / methods Galactose / analogs & derivatives Histocytochemistry Humans Invasive Pulmonary Aspergillosis / diagnosis Lung / microbiology pathology Mannans / analysis Microbiological Techniques Microscopy Polymerase Chain Reaction

来  源:   DOI:10.1093/mmy/myy103   PDF(Sci-hub)

Abstract:
Aspergillosis is more common among immunocompromised patients with neutropenia or immunosuppression due to corticosteroid use, and infections are typically of the lung or sinuses. For diagnosis, broncholaveolar lavages (BALs) and lung biopsies are the specimens of choice. Culture and microscopic examinations are a must have and laboratory results should immediately be reported to the clinic. Fungal elements (hyphae) display the proof of an infection if present in primarily steril specimens, independent of culture results. Microscopy should be performed preferably using optical brighteners and histopathology using Gomori\'s methenamine silver stain or Periodic acid-Schiff. Serum and BAL galactomannan assays are recommended as markers for the diagnosis of invasive aspergillosis, PCR should be considered in conjunction with other diagnostic tests. Antifungal treatment decreases GM sensitivity. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates.
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