Screening
Early diagnosis of invasive aspergillosis (IA) and prompt intervention improve outcome. In well-recognized high-risk groups, screening may lead to early detection.
Risk groups for screening
Patients with prolonged neutropenia (<0.5 x 10⁹ neutrophils/L [<500 neutrophils/mm³] for >10 days).
Allogeneic hematopoietic stem cell recipients with graft-versus-host disease (GVHD).
Screening test
Serum Aspergillus galactomannan (GM) antigen test is performed once or twice weekly as the screening test. A value of 0.5 or greater optical density index (twice on the same sample) is considered positive. Serially obtained GM values improve the sensitivity as compared with single values. Diagnostic utility of a single GM value is uncertain. Although sensitivity and specificity of this test in 2 high-risk groups are high, cases of IA can be missed. The sensitivity is low in those receiving mold-active antifungal drugs.[72][73]
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