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Vol. 39. Issue 2.
Pages 31-35 (April - June 2022)
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Vol. 39. Issue 2.
Pages 31-35 (April - June 2022)
Original article
Evaluation of the diagnostic accuracy of galactomannan from the bronchoalveolar lavage fluid of patients with suspected invasive pulmonary aspergillosis
Evaluación de la precisión diagnóstica del galactomanano en el lavado broncoalveolar de pacientes con sospecha de aspergilosis pulmonar invasiva
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Rafaela Manzoni Bernardia, Sizuane Rieger Hollerb, Ellis Gabriela Correa de Almeidab, Camila Antona,c, Felipe Dominguez Machadoa,c, Denise Rossato Silvaa,b,c,
Corresponding author
denise.rossato@terra.com.br

Corresponding author.
a Programa de Pós-Graduação em Ciências Pneumológicas da Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
b Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
c Hospital de Clínicas de Porto Alegre, Brazil
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Abstract
Background

Several studies to evaluate the accuracy of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) as a diagnostic tool have been carried out; however, there are still controversies about the optimal cut-off point of BALF GM.

Aims

The objective of this study was to determine the diagnostic accuracy and the optimal cut-off point on BALF GM from patients with suspected invasive pulmonary aspergillosis (IPA) in a tertiary care hospital.

Methods

A cross-sectional study with 188 patients (≥18 years) that had undergone a bronchoscopy with BAL due to suspected IPA was carried out. IPA was diagnosed according to the EORTC/MSG guidelines.

Results

The optimal optical density cut-off point for BALF GM was 0.67, with sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 70%, 32.3%, and 100%, respectively.

Conclusions

BALF GM detection proved to be a useful supplementary technique in the early diagnosis of IPA in both neutropenic and non-neutropenic patients.

Keywords:
Invasive pulmonary aspergillosis
Galactomannan
Bronchoalveolar lavage fluid
Hematological malignancies
Aspergillus
Resumen
Antecedentes

Diversos estudios han evaluado la precisión del galactomanano (GM) como herramienta diagnóstica en el líquido de lavado broncoalveolar (LBA); sin embargo, todavía existen controversias sobre el punto de corte óptimo de LBA GM.

Objetivos

El objetivo de este estudio fue determinar la precisión diagnóstica y el punto de corte óptimo en LBA GM de pacientes con sospecha de aspergilosis pulmonar invasora (API) en un hospital de tercer nivel.

Métodos

Se realizó un estudio transversal en el que fueron incluidos 188 pacientes (≥18años) a los que se les había realizado una broncoscopia con LBA por sospecha de API. La API se diagnosticó de acuerdo con las guías EORTC/MSG.

Resultados

El punto de corte óptimo para el valor densidad óptica de LBA GM fue de 0,67, con sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo del 100%, 70%, 32,3% y 100%, respectivamente.

Conclusiones

La detección de GM en LBA demostró ser un procedimiento útil en el diagnóstico precoz de la API, tanto en pacientes neutropénicos como en no neutropénicos.

Palabras clave:
Aspergilosis pulmonar invasiva
Galactomanano
Lavado broncoalveolar
Neoplasias hematológicas
Aspergillus

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