Mesh : Aspergillus / isolation & purification physiology Bronchoalveolar Lavage Fluid / microbiology Diabetes Complications / blood diagnosis microbiology Diagnosis, Differential Humans Invasive Pulmonary Aspergillosis / complications diagnosis microbiology Leukocyte Count Male Middle Aged Pneumonia / complications diagnosis microbiology Procalcitonin / blood Proteoglycans beta-Glucans / blood

来  源:   DOI:10.7754/Clin.Lab.2019.190135

Abstract:
BACKGROUND: We report an invasive pulmonary aspergillosis (IPA) with negative (1,3)-β-D-glucan and dynamically elevated white blood cells combined with procalcitonin proven by bronchoalveolar lavage fluid (BALF) culture.
METHODS: Appropriate laboratory tests are carried out. Chest CTs were performed to assess the lungs. The cause of infection was determined using BALF culture.
RESULTS: Serum (1,3)-β-D-glucan was negative, white blood cells and procalcitonin were significantly higher than normal. The bronchoscopy revealed obvious necrotic detritus and pseudo membrane in the trachea, left and right main bronchi, and branches. BALF culture revealed the presence of Aspergillus.
CONCLUSIONS: Negative (1,3)-β-D-glucan is not safe to rule out invasive pulmonary aspergillosis. BALF culture is critical for IPA diagnosis.
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