Point-of-care diagnostics for invasive aspergillosis: nearing the finish line.

Point-of-care diagnostics for invasive aspergillosis: nearing the finish line. Expert Rev Mol Diagn. 2020 Sep 09;: Authors: Jenks JD, Hoenigl M Abstract INTRODUCTION: The spectrum of disease caused by Aspergillus spp. is dependent on the immune system of the host, with invasive aspergillosis (IA) its most severe manifestation. Early and reliable diagnosis of Aspergillus disease is important to decrease associated morbidity and mortality from IA. AREAS COVERED: The following review searched Pub Med for literature published since 2007 and will give an update on the current point-of-care diagnostic strategies for the diagnosis of IA, discuss needed areas of improvement for these tests, and future directions. EXPERT OPINION: Several new diagnostic tests for IA - including point-of-care tests - are now available to complement conventional galactomannan (GM) testing. In particular, the Aspergillus-specific Lateral Flow Device (LFD) test and the sōna Aspergillus GM Lateral Flow Assay (LFA) are promising for the diagnosis of IA in patients with hematologic malignancy, although further evaluation in the non-hematology setting is needed. In addition, a true point-of-care test, particularly for easily obtained specimens like serum or urine that can be done at the bedside or in the Clinic in a matter of minutes is needed, such as the lateral flow dipstick test, which is under current evaluation. Lastly, improved diagnostic algorithms to diagnose IA in non-ne...
Source: Expert Review of Molecular Diagnostics - Category: Laboratory Medicine Tags: Expert Rev Mol Diagn Source Type: research

Related Links:

A 69-year-old man with newly diagnosed B-precursor acute lymphoblastic leukemia (B-ALL) had impaired consciousness (Glasgow coma scale [GCS] E4V4M6) on day 24 of remission induction therapy. Serum beta-D-glucan (61.0  pg/μL) and Aspergillus galactomannan antigens in the serum and cerebrospinal fluid (CSF) (both ≥5.0) were elevated. Computed tomography showed a nodule in the left lung. Magnetic resonance imaging (MRI) revealed multiple brain lesions, and brain biopsy confirmed aspergillosis (Fig. 1) accordin g to the updated invasive fungal disease definition (Donnelly et al., 2019).
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Medical Imagery Source Type: research
Invasive fungal infections caused by Aspergillus (A.) and Mucorales species still represent life-threatening diseases in immunocompromised individuals, and deeper knowledge about fungal interactions with elements of innate immunity, such as complement and platelets, appears essential for optimized therapy. Previous studies showed that galactosaminogalactan secreted by A. fumigatus and A. flavus is deposited on platelets, thereby inducing their activation. Since the altered platelet surface is a putative trigger for complement activation, we aimed to study the interplay of platelets with complement in the presence of fungal...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Isolated aspergillus laryngitis is rare and often diagnosed after surgical excision or biopsy for a suspected premalignant or malignant pathology. Unlike other systemic or localized aspergillosis, there are no specific guidelines for isolated laryngeal aspergillosis. Our experience of dealing with a wide variety of isolated laryngeal aspergillosis showed that this entity is very responsive to medical therapy, making extensive debridement (as often carried out in surgically accessible aspergillosis) unnecessary as it would invariably lead to long-term dysphonia.
Source: Journal of Voice - Category: ENT & OMF Authors: Source Type: research
Abstract Bacterial or virus co-infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in many studies, however, the knowledge on Aspergillus co-infection among patients with coronavirus disease 2019 (COVID-19) was limited. This literature review aims to explore and describe the updated information about COVID-19 associated with pulmonary aspergillosis. We found that Aspergillus spp. can cause co-infections in patients with COVID-19, especially in severe/critical illness. The incidence of IPA in COVID-19 ranged from 19.6% to 33.3%. Acute respiratory distress syndrome requiri...
Source: Journal of Microbiology, Immunology, and Infection - Category: Microbiology Authors: Tags: J Microbiol Immunol Infect Source Type: research
We report the case of a 17-year-old male who presented with complaints of fever, cough and increasing shortness of breath for 3 weeks. Patient had breathlessness with seasonal variation. Patient had right lower lobe consolidation with pleural effusion which did not respond to antibiotics. Pleural fluid was exudate with neutrophilic predominance and low ADA. Skin prick test for Aspergillus fumigatus was positive, both total IgE and specific IgE against Aspergillus fumigatus were raised. PMID: 32945640 [PubMed - as supplied by publisher]
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Advanced chronic obstructive pulmonary disease (COPD) often leads to hospitalisation and invasive aspergillosis (IA) is a serious complication. Aspergillus sensitisation may worsen symptoms in COPD.
Source: BMC Pulmonary Medicine - Category: Respiratory Medicine Authors: Tags: Research article Source Type: research
Delayed natural killer (NK) cell reconstitution after allogeneic stem cell transplantation (alloSCT) is associated with a higher risk of developing invasive aspergillosis. The interaction of NK cells with the human pathogen Aspergillus (A.) fumigatus is mediated by the fungal recognition receptor CD56, which is relocated to the fungal interface after contact. Blocking of CD56 signaling inhibits the fungal mediated chemokine secretion of MIP-1α, MIP-1β, and RANTES and reduces cell activation, indicating a functional role of CD56 in fungal recognition. We collected peripheral blood from recipients of an allograft ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
We report the case of a young immunocompetent male with no underlying lung disease, who presented with an incidentally detected 'infective mass' lesion in the lung associated with minimal respiratory symptoms. The diagnostic challenges posed by the unusual clinical, radiological and histological picture as well as the therapeutic dilemmas faced are discussed in this report. PMID: 32893609 [PubMed - in process]
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Abstract The mammalian immune system can tune its inflammatory response to the threat level posed by an invading pathogen. It is well established that the host utilizes numerous 'patterns of pathogenicity', such as microbial growth, invasion, and viability, to achieve this tuning during bacterial infections. This review discusses how this notion fits during fungal infection, particularly regarding Aspergillus fumigatus infection. Moreover, how the environmental niches filled by A. fumigatus may drive the evolution of the fungal traits responsible for inducing the strain-specific inflammatory responses that have be...
Source: Current Opinion in Microbiology - Category: Microbiology Authors: Tags: Curr Opin Microbiol Source Type: research
Conclusion: Being one of the few cases reporting a successful outcome for brain aspergilloma in an immunocompetent patient after complete surgical resection and amphotericin B and itraconazole therapy, we sought to reveal novel insight into brain aspergillosis. PMID: 32874714 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
More News: Aspergillosis | Aspergillus | Cancer & Oncology | Hematology | Laboratory Medicine