Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia

Background: The Computed Tomography (CT) features of Invasive Pulmonary Aspergillosis (IPA) include Airway and Angio Invasive type. However those features are nonspecific and diagnosis should be made in conjunction with EORTC-MSG criteria. In this study, we evaluated the association between the CT f...

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Main Author: Idris, Nurul Ain Mat
Format: Thesis
Language:English
Published: 2018
Subjects:
Online Access:http://eprints.usm.my/47463/
http://eprints.usm.my/47463/1/Dr.%20Nurul%20Ain%20Mat%20Idris-24%20pages.pdf
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author Idris, Nurul Ain Mat
author_facet Idris, Nurul Ain Mat
author_sort Idris, Nurul Ain Mat
building USM Institutional Repository
collection Online Access
description Background: The Computed Tomography (CT) features of Invasive Pulmonary Aspergillosis (IPA) include Airway and Angio Invasive type. However those features are nonspecific and diagnosis should be made in conjunction with EORTC-MSG criteria. In this study, we evaluated the association between the CT findings and Galactomannan and Aspergillus specific PCR in patient with febrile neutropenia. Methods: Patients with hematological malignancy who had persistent febrile neutropenia of 3 days or more despite of antibiotic underwent CT thorax within 2 weeks of clinical diagnosis of IPA. Blood serum for Galactomannan assay and Aspergillus specific PCR were performed. Changes of CT thorax were documented and association between mycological findings were analyzed using Fisher exact test. Significant association taken at p value of < 0.05. Results: A total of 26 patients were enrolled in our study. CT findings were positive in 17(65.4%), 8(30.8%) was positive for Galactomannan and 9(34.6%) for PCR. There was significant association between PCR and CT thorax finding (p value 0.009, 95% CI) but not between Galactomannan and CT Thorax (p value 0.667, 95% CI). Conclusion: Combination of PCR and CT thorax can be used as a non-invasive tools for early diagnosis of IPA. The Aspergillus specific PCR might to be consider as one of the mycological criteria in EORTC-MSG for diagnosis of IPA in the future.
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spelling usm-474632020-10-08T03:43:49Z http://eprints.usm.my/47463/ Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia Idris, Nurul Ain Mat RA643-645 Disease (Communicable and noninfectious) and public health Background: The Computed Tomography (CT) features of Invasive Pulmonary Aspergillosis (IPA) include Airway and Angio Invasive type. However those features are nonspecific and diagnosis should be made in conjunction with EORTC-MSG criteria. In this study, we evaluated the association between the CT findings and Galactomannan and Aspergillus specific PCR in patient with febrile neutropenia. Methods: Patients with hematological malignancy who had persistent febrile neutropenia of 3 days or more despite of antibiotic underwent CT thorax within 2 weeks of clinical diagnosis of IPA. Blood serum for Galactomannan assay and Aspergillus specific PCR were performed. Changes of CT thorax were documented and association between mycological findings were analyzed using Fisher exact test. Significant association taken at p value of < 0.05. Results: A total of 26 patients were enrolled in our study. CT findings were positive in 17(65.4%), 8(30.8%) was positive for Galactomannan and 9(34.6%) for PCR. There was significant association between PCR and CT thorax finding (p value 0.009, 95% CI) but not between Galactomannan and CT Thorax (p value 0.667, 95% CI). Conclusion: Combination of PCR and CT thorax can be used as a non-invasive tools for early diagnosis of IPA. The Aspergillus specific PCR might to be consider as one of the mycological criteria in EORTC-MSG for diagnosis of IPA in the future. 2018 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/47463/1/Dr.%20Nurul%20Ain%20Mat%20Idris-24%20pages.pdf Idris, Nurul Ain Mat (2018) Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia. Masters thesis, Universiti Sains Malaysia.
spellingShingle RA643-645 Disease (Communicable and noninfectious) and public health
Idris, Nurul Ain Mat
Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
title Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
title_full Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
title_fullStr Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
title_full_unstemmed Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
title_short Association of CT thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
title_sort association of ct thorax findings with galactomannan and aspergillus-specific polymerase chain reaction for diagnosis of invasive aspergillosis in patient with febrile neutropenia
topic RA643-645 Disease (Communicable and noninfectious) and public health
url http://eprints.usm.my/47463/
http://eprints.usm.my/47463/1/Dr.%20Nurul%20Ain%20Mat%20Idris-24%20pages.pdf