Diagnosis of Pulmonary Aspergillosis

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  • Takazono Takahiro
    Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences Department of Respiratory Medicine, Nagasaki University Hospital

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  • 肺アスペルギルス症の診断

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Pulmonary aspergillosis is a refractory infectious disease that occurs in patients with impaired immunity or pulmonary underlying diseases. It is roughly categorized into invasive pulmonary aspergillosis and chronic pulmonary aspergillosis depending on their clinical course or the type of underlying diseases. Diagnosing aspergillosis requires a review of background information or radiological findings. As the sensitivity of fungal culture is from sputum low, bronchoscopy must be performed to obtain specimen from the site of infection for fungal culture or pathological examination. However, bronchoscopy is usually avoided if the patient has poor general conditions. Hence, a better auxiliary diagnostic method is needed. Galactomannan antigen has good accuracy for the diagnosis of invasive pulmonary aspergillosis, but not for chronic pulmonary aspergillosis. Although the Aspergillus precipitating antibody test has a relatively good sensitivity and specificity for the diagnosis of chronic pulmonary aspergillosis, it is not covered by the Japanese medical insurance system. Approval of Aspergillus IgG EIA antibody tests or the development of new diagnostic methods for pulmonary aspergillosis is necessary.

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