Invasive Aspergillosis: Serologic Diagnosis

Abstract

Invasive aspergillosis is a common infection in immunocompromised patients, which, when untreated, is uniformly fatal. Although amphotericin B currently is the drug of choice for invasive aspergillosis, this agent is toxic and is, at times, not successful, particularly in immunosuppressed patients. Early treatment may improve survival (Aisner et al. 1977), but the diagnosis of invasive aspergillosis is difficult to establish because cultures of blood and other body fluids are rarely positive. Serologic techniques have been used in an attempt to establish an antemortem diagnosis of invasive aspergillosis. Initial attempts by our laboratory (Marier et al. 1979) and by others (de Repentigny 1989) were directed at detecting antibody to Aspergillus. However, patients at risk for developing invasive aspergillosis often do not develop antibodies to Aspergillus, especially early in the course of their infection. Thus, aspergillus antibody has not been helpful as a diagnostic tool for not identifying invasive aspergillosis. Subsequent research in our laboratory, and others, has attempted to diagnose invasive aspergillosis on the basis of circulating aspergillus antigen. The intent has been to develop a reliable method that would establish an early diagnosis which would permit prompt antifungal therapy and an improved clinial outcome.