Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis?
Background Several previous studies have shown cavitary lung lesions in old pulmonary tuberculosis (PTB) increase the risk of fungus ball. Detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is also proposed as a diagnostic approach for the fungus ball. Objectives We evaluated the diagno...
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| Veröffentlicht in: | Mycoses 2020-07, Vol.63 (7), p.755-761 |
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| creator | Gheisari, Maryam Basharzad, Niloofar Yazdani Charati, Jamshid Mirenayat, Maryam Sadat Pourabdollah, Mihan Ansari, Saham Mortezaee, Vida Abastabar, Mahdi Jafarzadeh, Jalal Haghani, Iman Hedayati, Mohammad T. |
| description | Background
Several previous studies have shown cavitary lung lesions in old pulmonary tuberculosis (PTB) increase the risk of fungus ball. Detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is also proposed as a diagnostic approach for the fungus ball.
Objectives
We evaluated the diagnosis of fungus balls and GM levels in BAL samples in PTB patients.
Methods
A total of 110 PTB patients were evaluated for fungus ball during 2017‐2019. The patients were evaluated for radiological, histopathological results and mycological findings of BAL including GM detection and culture. The sensitivity, specificity and positive and negative predictive value for GM test were calculated. The optimal cut‐off for BAL GM testing was determined by receiver operating characteristic (ROC).
Results
Of 110 PTB patients, nine (8.18%) showed fungus ball, all with old PTB. The molecularly confirmed Aspergillus species were A. flavus, A. fumigatus and A. ochraceus. The sensitivity and specificity of BAL GM ≥ 0.5 in old PTB patients with fungus ball were 100%, 41.5%, respectively. The statistical analysis of the mean ± SEM of BAL GM levels was demonstrated a higher levels of GM in patients with fungus ball/aspergilloma compared to old PTB patients without fungus ball/aspergilloma. The optimal cut‐off value for BAL GM was determined as 0.50 by ROC curve analysis.
Conclusion
According to our results, we can recommend the detection of GM in BAL samples as a diagnostic approach for fungus ball in PTB patients. |
| doi_str_mv | 10.1111/myc.13099 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2400519508</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2412750585</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-8f5207af62281024fce72e3d9b9a7db23c66285303461c497324a6274639dfe93</originalsourceid><addsrcrecordid>eNp1kb1uFDEURi0EIstCwQsgSzRQbOKf8XhME0UrEpCCaKCgGt3x2LuOPPZgjxPtG_DYONlAgcRtbnN07nf1IfSaklNa52w66FPKiVJP0Io2XG2IIPIpWhHF-UY2RJ6gFznfEEKlYu1zdMIZ74RidIV-XYEHvcQJQoCAR7MYvbgYsAt4SDHofQR_a6KHhD3cws5g64sb8wd8gUcHuxDz4jSGeU4R9B7bmLAtYVcyHsD7e88MizNhyfjOLXs8Fz_FAOmAlzKYpIuP2eXzl-iZBZ_Nq8e9Rt8vP37bftpcf736vL243mgu6medFYxIsC1jHSWssdpIZvioBgVyHBjXbcs6wQlvWqobJTlroGWyabkarVF8jd4dvTXvz2Ly0k8ua-M9BBNL7llDiKBKkK6ib_9Bb2JJoaarFGVSEFEvrdH7I6VTzDkZ28_JTfW_npL-vp6-1tM_1FPZN4_GMkxm_Ev-6aMCZ0fgznlz-L-p__Jje1T-Bj7Empo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2412750585</pqid></control><display><type>article</type><title>Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis?</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Gheisari, Maryam ; Basharzad, Niloofar ; Yazdani Charati, Jamshid ; Mirenayat, Maryam Sadat ; Pourabdollah, Mihan ; Ansari, Saham ; Mortezaee, Vida ; Abastabar, Mahdi ; Jafarzadeh, Jalal ; Haghani, Iman ; Hedayati, Mohammad T.</creator><creatorcontrib>Gheisari, Maryam ; Basharzad, Niloofar ; Yazdani Charati, Jamshid ; Mirenayat, Maryam Sadat ; Pourabdollah, Mihan ; Ansari, Saham ; Mortezaee, Vida ; Abastabar, Mahdi ; Jafarzadeh, Jalal ; Haghani, Iman ; Hedayati, Mohammad T.</creatorcontrib><description>Background
Several previous studies have shown cavitary lung lesions in old pulmonary tuberculosis (PTB) increase the risk of fungus ball. Detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is also proposed as a diagnostic approach for the fungus ball.
Objectives
We evaluated the diagnosis of fungus balls and GM levels in BAL samples in PTB patients.
Methods
A total of 110 PTB patients were evaluated for fungus ball during 2017‐2019. The patients were evaluated for radiological, histopathological results and mycological findings of BAL including GM detection and culture. The sensitivity, specificity and positive and negative predictive value for GM test were calculated. The optimal cut‐off for BAL GM testing was determined by receiver operating characteristic (ROC).
Results
Of 110 PTB patients, nine (8.18%) showed fungus ball, all with old PTB. The molecularly confirmed Aspergillus species were A. flavus, A. fumigatus and A. ochraceus. The sensitivity and specificity of BAL GM ≥ 0.5 in old PTB patients with fungus ball were 100%, 41.5%, respectively. The statistical analysis of the mean ± SEM of BAL GM levels was demonstrated a higher levels of GM in patients with fungus ball/aspergilloma compared to old PTB patients without fungus ball/aspergilloma. The optimal cut‐off value for BAL GM was determined as 0.50 by ROC curve analysis.
Conclusion
According to our results, we can recommend the detection of GM in BAL samples as a diagnostic approach for fungus ball in PTB patients.</description><identifier>ISSN: 0933-7407</identifier><identifier>EISSN: 1439-0507</identifier><identifier>DOI: 10.1111/myc.13099</identifier><identifier>PMID: 32385921</identifier><language>eng</language><publisher>Germany: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alveoli ; Aspergilloma ; Aspergillus - classification ; Aspergillus - isolation & purification ; bronchoalveolar lavage ; Bronchoalveolar Lavage Fluid - chemistry ; Bronchus ; Female ; Fungi ; Fungus balls ; galactomannan ; Humans ; Invasive Pulmonary Aspergillosis - diagnosis ; Invasive Pulmonary Aspergillosis - microbiology ; Iran ; Lavage ; Male ; Mannans - analysis ; Middle Aged ; Predictive Value of Tests ; pulmonary tuberculosis ; ROC Curve ; Statistical analysis ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary - complications ; Tuberculosis, Pulmonary - microbiology ; Young Adult</subject><ispartof>Mycoses, 2020-07, Vol.63 (7), p.755-761</ispartof><rights>2020 Blackwell Verlag GmbH</rights><rights>2020 Blackwell Verlag GmbH.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-8f5207af62281024fce72e3d9b9a7db23c66285303461c497324a6274639dfe93</citedby><cites>FETCH-LOGICAL-c3539-8f5207af62281024fce72e3d9b9a7db23c66285303461c497324a6274639dfe93</cites><orcidid>0000-0002-0016-2849 ; 0000-0001-6415-4648</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fmyc.13099$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fmyc.13099$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32385921$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gheisari, Maryam</creatorcontrib><creatorcontrib>Basharzad, Niloofar</creatorcontrib><creatorcontrib>Yazdani Charati, Jamshid</creatorcontrib><creatorcontrib>Mirenayat, Maryam Sadat</creatorcontrib><creatorcontrib>Pourabdollah, Mihan</creatorcontrib><creatorcontrib>Ansari, Saham</creatorcontrib><creatorcontrib>Mortezaee, Vida</creatorcontrib><creatorcontrib>Abastabar, Mahdi</creatorcontrib><creatorcontrib>Jafarzadeh, Jalal</creatorcontrib><creatorcontrib>Haghani, Iman</creatorcontrib><creatorcontrib>Hedayati, Mohammad T.</creatorcontrib><title>Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis?</title><title>Mycoses</title><addtitle>Mycoses</addtitle><description>Background
Several previous studies have shown cavitary lung lesions in old pulmonary tuberculosis (PTB) increase the risk of fungus ball. Detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is also proposed as a diagnostic approach for the fungus ball.
Objectives
We evaluated the diagnosis of fungus balls and GM levels in BAL samples in PTB patients.
Methods
A total of 110 PTB patients were evaluated for fungus ball during 2017‐2019. The patients were evaluated for radiological, histopathological results and mycological findings of BAL including GM detection and culture. The sensitivity, specificity and positive and negative predictive value for GM test were calculated. The optimal cut‐off for BAL GM testing was determined by receiver operating characteristic (ROC).
Results
Of 110 PTB patients, nine (8.18%) showed fungus ball, all with old PTB. The molecularly confirmed Aspergillus species were A. flavus, A. fumigatus and A. ochraceus. The sensitivity and specificity of BAL GM ≥ 0.5 in old PTB patients with fungus ball were 100%, 41.5%, respectively. The statistical analysis of the mean ± SEM of BAL GM levels was demonstrated a higher levels of GM in patients with fungus ball/aspergilloma compared to old PTB patients without fungus ball/aspergilloma. The optimal cut‐off value for BAL GM was determined as 0.50 by ROC curve analysis.
Conclusion
According to our results, we can recommend the detection of GM in BAL samples as a diagnostic approach for fungus ball in PTB patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alveoli</subject><subject>Aspergilloma</subject><subject>Aspergillus - classification</subject><subject>Aspergillus - isolation & purification</subject><subject>bronchoalveolar lavage</subject><subject>Bronchoalveolar Lavage Fluid - chemistry</subject><subject>Bronchus</subject><subject>Female</subject><subject>Fungi</subject><subject>Fungus balls</subject><subject>galactomannan</subject><subject>Humans</subject><subject>Invasive Pulmonary Aspergillosis - diagnosis</subject><subject>Invasive Pulmonary Aspergillosis - microbiology</subject><subject>Iran</subject><subject>Lavage</subject><subject>Male</subject><subject>Mannans - analysis</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>pulmonary tuberculosis</subject><subject>ROC Curve</subject><subject>Statistical analysis</subject><subject>Tomography, X-Ray Computed</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Pulmonary - complications</subject><subject>Tuberculosis, Pulmonary - microbiology</subject><subject>Young Adult</subject><issn>0933-7407</issn><issn>1439-0507</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kb1uFDEURi0EIstCwQsgSzRQbOKf8XhME0UrEpCCaKCgGt3x2LuOPPZgjxPtG_DYONlAgcRtbnN07nf1IfSaklNa52w66FPKiVJP0Io2XG2IIPIpWhHF-UY2RJ6gFznfEEKlYu1zdMIZ74RidIV-XYEHvcQJQoCAR7MYvbgYsAt4SDHofQR_a6KHhD3cws5g64sb8wd8gUcHuxDz4jSGeU4R9B7bmLAtYVcyHsD7e88MizNhyfjOLXs8Fz_FAOmAlzKYpIuP2eXzl-iZBZ_Nq8e9Rt8vP37bftpcf736vL243mgu6medFYxIsC1jHSWssdpIZvioBgVyHBjXbcs6wQlvWqobJTlroGWyabkarVF8jd4dvTXvz2Ly0k8ua-M9BBNL7llDiKBKkK6ib_9Bb2JJoaarFGVSEFEvrdH7I6VTzDkZ28_JTfW_npL-vp6-1tM_1FPZN4_GMkxm_Ev-6aMCZ0fgznlz-L-p__Jje1T-Bj7Empo</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Gheisari, Maryam</creator><creator>Basharzad, Niloofar</creator><creator>Yazdani Charati, Jamshid</creator><creator>Mirenayat, Maryam Sadat</creator><creator>Pourabdollah, Mihan</creator><creator>Ansari, Saham</creator><creator>Mortezaee, Vida</creator><creator>Abastabar, Mahdi</creator><creator>Jafarzadeh, Jalal</creator><creator>Haghani, Iman</creator><creator>Hedayati, Mohammad T.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0016-2849</orcidid><orcidid>https://orcid.org/0000-0001-6415-4648</orcidid></search><sort><creationdate>202007</creationdate><title>Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis?</title><author>Gheisari, Maryam ; Basharzad, Niloofar ; Yazdani Charati, Jamshid ; Mirenayat, Maryam Sadat ; Pourabdollah, Mihan ; Ansari, Saham ; Mortezaee, Vida ; Abastabar, Mahdi ; Jafarzadeh, Jalal ; Haghani, Iman ; Hedayati, Mohammad T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-8f5207af62281024fce72e3d9b9a7db23c66285303461c497324a6274639dfe93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alveoli</topic><topic>Aspergilloma</topic><topic>Aspergillus - classification</topic><topic>Aspergillus - isolation & purification</topic><topic>bronchoalveolar lavage</topic><topic>Bronchoalveolar Lavage Fluid - chemistry</topic><topic>Bronchus</topic><topic>Female</topic><topic>Fungi</topic><topic>Fungus balls</topic><topic>galactomannan</topic><topic>Humans</topic><topic>Invasive Pulmonary Aspergillosis - diagnosis</topic><topic>Invasive Pulmonary Aspergillosis - microbiology</topic><topic>Iran</topic><topic>Lavage</topic><topic>Male</topic><topic>Mannans - analysis</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>pulmonary tuberculosis</topic><topic>ROC Curve</topic><topic>Statistical analysis</topic><topic>Tomography, X-Ray Computed</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Pulmonary - complications</topic><topic>Tuberculosis, Pulmonary - microbiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gheisari, Maryam</creatorcontrib><creatorcontrib>Basharzad, Niloofar</creatorcontrib><creatorcontrib>Yazdani Charati, Jamshid</creatorcontrib><creatorcontrib>Mirenayat, Maryam Sadat</creatorcontrib><creatorcontrib>Pourabdollah, Mihan</creatorcontrib><creatorcontrib>Ansari, Saham</creatorcontrib><creatorcontrib>Mortezaee, Vida</creatorcontrib><creatorcontrib>Abastabar, Mahdi</creatorcontrib><creatorcontrib>Jafarzadeh, Jalal</creatorcontrib><creatorcontrib>Haghani, Iman</creatorcontrib><creatorcontrib>Hedayati, Mohammad T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Mycoses</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gheisari, Maryam</au><au>Basharzad, Niloofar</au><au>Yazdani Charati, Jamshid</au><au>Mirenayat, Maryam Sadat</au><au>Pourabdollah, Mihan</au><au>Ansari, Saham</au><au>Mortezaee, Vida</au><au>Abastabar, Mahdi</au><au>Jafarzadeh, Jalal</au><au>Haghani, Iman</au><au>Hedayati, Mohammad T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis?</atitle><jtitle>Mycoses</jtitle><addtitle>Mycoses</addtitle><date>2020-07</date><risdate>2020</risdate><volume>63</volume><issue>7</issue><spage>755</spage><epage>761</epage><pages>755-761</pages><issn>0933-7407</issn><eissn>1439-0507</eissn><abstract>Background
Several previous studies have shown cavitary lung lesions in old pulmonary tuberculosis (PTB) increase the risk of fungus ball. Detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is also proposed as a diagnostic approach for the fungus ball.
Objectives
We evaluated the diagnosis of fungus balls and GM levels in BAL samples in PTB patients.
Methods
A total of 110 PTB patients were evaluated for fungus ball during 2017‐2019. The patients were evaluated for radiological, histopathological results and mycological findings of BAL including GM detection and culture. The sensitivity, specificity and positive and negative predictive value for GM test were calculated. The optimal cut‐off for BAL GM testing was determined by receiver operating characteristic (ROC).
Results
Of 110 PTB patients, nine (8.18%) showed fungus ball, all with old PTB. The molecularly confirmed Aspergillus species were A. flavus, A. fumigatus and A. ochraceus. The sensitivity and specificity of BAL GM ≥ 0.5 in old PTB patients with fungus ball were 100%, 41.5%, respectively. The statistical analysis of the mean ± SEM of BAL GM levels was demonstrated a higher levels of GM in patients with fungus ball/aspergilloma compared to old PTB patients without fungus ball/aspergilloma. The optimal cut‐off value for BAL GM was determined as 0.50 by ROC curve analysis.
Conclusion
According to our results, we can recommend the detection of GM in BAL samples as a diagnostic approach for fungus ball in PTB patients.</abstract><cop>Germany</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32385921</pmid><doi>10.1111/myc.13099</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0016-2849</orcidid><orcidid>https://orcid.org/0000-0001-6415-4648</orcidid></addata></record> |
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| ispartof | Mycoses, 2020-07, Vol.63 (7), p.755-761 |
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| subjects | Adolescent Adult Aged Aged, 80 and over Alveoli Aspergilloma Aspergillus - classification Aspergillus - isolation & purification bronchoalveolar lavage Bronchoalveolar Lavage Fluid - chemistry Bronchus Female Fungi Fungus balls galactomannan Humans Invasive Pulmonary Aspergillosis - diagnosis Invasive Pulmonary Aspergillosis - microbiology Iran Lavage Male Mannans - analysis Middle Aged Predictive Value of Tests pulmonary tuberculosis ROC Curve Statistical analysis Tomography, X-Ray Computed Tuberculosis Tuberculosis, Pulmonary - complications Tuberculosis, Pulmonary - microbiology Young Adult |
| title | Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis? |
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