Serum Galactomannan Assay Positivity For Invasive Pulmonary Aspergillosis Among Chronic Obstructive Pulmonary Disease Patients In A Tertiary Care Hospital
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Abstract
Invasive Pulmonary Aspergillosis (IPA) is an important opportunistic infection in critically ill patients with various underlying risk factors and is associated with a high degree of morbidity and mortality. In recent years, it has been reported that the incidence of IPA has also increased in patients with chronic obstructive pulmonary disease (COPD).
Aims & Objectives: The purpose of the study was to determine the Serum Galactomannan Assay positivity rate for Invasive Pulmonary Aspergillosis in Chronic Obstructive Pulmonary Disease patients and to study co-morbid conditions and risk factors for invasive aspergillosis.
Materials & Methods: The study population included 56 patients admitted to PKTB hospital, Mysore with COPD/AECOPD. Serum Galactomannan antigen detection by ELISA was done in all subjects.
Results: Serum Galactomannan assay positivity was seen in 10(17.85%) of the study population. The clinical features seen in the study population were dyspnea (98.2%), chest pain (98.2%), cough with expectoration (83.9%), Haemoptysis (12.5%), fever (10.7%), at the time of presentation. Nonspecific Consolidation(46%) comprised the major X-Ray finding followed by Diffuse Patchy Infiltration (29%). Co-morbidities like Diabetes Mellitus (71.4%), Smoking (83.9%), prior administration of steroid (73.2%), past history of COPD (66.1%), Pulmonary Tuberculosis (10.71%) was seen in the study population.
Conclusion: Serum GM assay could increase the diagnostic sensitivity for IPA in COPD patients. Further studies with attention to the assessment of antifungal therapy, false-positive results and utility of the test are needed.
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