Diagnosis
Diagnosis of Invasive Aspergillosis
Determine site of infection by signs, symptoms, radiography, host factors
Establish proven or probable IA (see Key Points for definitions)
Proven/Probable
Culture confirmation; requires
recovery of organism from
normally sterile site
Alternative Testing to
Establish a Probable Diagnosis
Satisfy criteria for probable IA
with surrogate nonculture-based
diagnosis:
• Positive galactomannan EIA1
or
• Positive beta-glucan assay +
radiologically compatible CT
scan2 in immunocompromised
host with clinical findings of
infections
Standard Diagnostic Procedures3
• Bronchoalveolar lavage (BAL)
• Transthoracic percutaneous needle aspirate
• Video-assisted thoracoscopic biopsy
• Cultures of material obtained plated on fungal media
for growth of Aspergillus spp
For Patients Unable to Undergo Invasive Testing
Use nonculture-based surrogate markers as in
alternative testing to establish a probable diagnosis
This enzyme immunoassay (EIA) demonstrates good sensitivity for detection of IA in patients with
hematological malignancy, but is less sensitive in non-neutropenic patients.
2
Recognition of "halo sign" and "air-crescent" by CT scan facilitates diagnosis of IA in
immunocompromised hematology patients–these radiologic features are characteristic, but are not
diagnostic of IA.
3
May produce false negatives where procedures cannot be performed directly in affected area. Testing BAL
fluid for galactomannan may increase yield of positive results.
1
