Detecting serum galactomannan to diagnose acute invasive Aspergillus sinusitis: a meta-analysis

Chang, Suk Won; Nam, Jae Sung; Ha, Jong Gyun; Kim, Na Won; Almarzouq, Wasan F.; Kim, Chang Hoon; Yoon, Joo Heon; Cho, Hyung‐Ju

doi:10.1007/s00405-021-06857-8

Cited by 8 publications

(10 citation statements)

References 26 publications

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“…7,19,27,61,68 Multiple studies estimated GM specificity of ≥95%; one conflicting report estimated 60% specificity. 19,68,77,79 These data indicate GM can supplement diagnosis of AIFS in combination with microscopy/histopathology and culture/PCR. However, the assay does not identify the pathogen and may be susceptible to false positives and false negatives.…”

Section: Galactomannanmentioning

confidence: 88%

“…Although frequently treated as a biomarker for Aspergillus spp IFIs, GM cross‐reacts with a broad array of organisms including Fusarium and mucormycetes 7,78 . Reported cross‐reactivity with β‐lactam antibiotics is disputed 23,76–78 . A recent meta‐analysis estimated an area under the curve (AUC) of 0.65 for diagnosing AIFS with Aspergillus spp at a cutoff GM index of 0.5 80 .…”

Section: Laboratory and Microbiology Diagnosticsmentioning

confidence: 99%

“…Sensitivity was frequently estimated at 40% to 45%, with outliers of 15.7% and 65% 7,19,27,61,68 . Multiple studies estimated GM specificity of ≥95%; one conflicting report estimated 60% specificity 19,68,77,79 …”

Section: Laboratory and Microbiology Diagnosticsmentioning

confidence: 99%

“…Like BDG, galactomannan (GM) is a fungal cell wall component and established serum biomarker of invasive fungal infections that can aid in, but is not sufficient for, diagnosis of AIFS. 7,19,27,68,[77][78][79] Although frequently treated as a biomarker for Aspergillus spp IFIs, GM cross-reacts with a broad array of organisms including Fusarium and mucormycetes. 7,78 Reported cross-reactivity with β-lactam antibiotics is disputed.…”

Section: Galactomannanmentioning

confidence: 99%

“…7,78 Reported cross-reactivity with β-lactam antibiotics is disputed. 23,[76][77][78] A recent meta-analysis estimated an area under the curve (AUC) of 0.65 for diagnosing AIFS with Aspergillus spp at a cutoff GM index of 0.5. 80 Sensitivity was frequently estimated at 40% to 45%, with outliers of 15.7% and 65%.…”

Section: Galactomannanmentioning

confidence: 99%

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Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Roland

Humphreys

et al. 2023

Int Forum Allergy Rhinol

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BackgroundAcute invasive fungal sinusitis (AIFS) is an aggressive disease that requires prompt diagnosis and multidisciplinary treatment given its rapid progression. However, there is currently no consensus on diagnosis, prognosis, and management strategies for AIFS, with multiple modalities routinely employed. The purpose of this multi‐institutional and multidisciplinary evidence‐based review with recommendations (EBRR) is to thoroughly review the literature on AIFS, summarize the existing evidence, and provide recommendations on the management of AIFS.MethodsThe PubMed, EMBASE, and Cochrane databases were systematically reviewed from inception through January 2022. Studies evaluating management for orbital, non‐sinonasal head and neck, and intracranial manifestations of AIFS were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on management principles for AIFS were generated.ResultsA review and evaluation of published literature was performed on 12 topics surrounding AIFS (signs and symptoms, laboratory and microbiology diagnostics, endoscopy, imaging, pathology, surgery, medical therapy, management of extrasinus extension, reversing immunosuppression, and outcomes and survival). The aggregate quality of evidence was varied across reviewed domains.ConclusionBased on the currently available evidence, judicious utilization of a combination of history and physical examination, laboratory and histopathologic techniques, and endoscopy provide the cornerstone for accurate diagnosis of AIFS. In addition, AIFS is optimally managed by a multidisciplinary team via a combination of surgery (including resection whenever possible), antifungal therapy, and correcting sources of immunosuppression. Higher quality (i.e., prospective) studies are needed to better define the roles of each modality and determine diagnosis and treatment algorithms.

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Section: Galactomannanmentioning

confidence: 88%

Section: Laboratory and Microbiology Diagnosticsmentioning

confidence: 99%

Section: Laboratory and Microbiology Diagnosticsmentioning

confidence: 99%

Section: Galactomannanmentioning

confidence: 99%

Section: Galactomannanmentioning

confidence: 99%

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Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Roland

Humphreys

et al. 2023

Int Forum Allergy Rhinol

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Developments in Fungal Serology

White

2023

Curr Fungal Infect Rep

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Purpose of Review The true incidence of fungal disease is hampered by conventionally poor diagnostic tests, limited access to advanced diagnostics, and limited surveillance. The availability of serological testing has been available for over two decades and generally underpins the modern diagnosis of the most common forms of fungal disease. This review will focus on technical developments of serological tests for the diagnosis of fungal disease, describing advances in clinical performance when available. Recent Findings Despite their longevity, technical, clinical, and performance limitations remain, and tests specific for fungal pathogens outside the main pathogens are lacking. The availability of LFA and automated systems, capable of running multiple different tests, represents significant developments, but clinical performance data is variable and limited. Summary Fungal serology has significantly advanced the diagnosis of the main fungal infections, with LFA availability increasing accessibility to testing. Combination testing has the potential to overcome performance limitations.

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Utility of galactomannan diagnostic assay in rhino-orbito-cerebral mycosis in COVID-19 patients

Chatterjee,

Taneja,

Agarwal

et al. 2024

Indian Journal of Medical Microbiology

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Detecting serum galactomannan to diagnose acute invasive Aspergillus sinusitis: a meta-analysis

Cited by 8 publications

References 26 publications

Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Developments in Fungal Serology

Utility of galactomannan diagnostic assay in rhino-orbito-cerebral mycosis in COVID-19 patients

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