Role of (1-->3)-beta-D-glucan in the diagnosis of invasive aspergillosis.

Medical Mycology
Francisco M Marty, Sophia Koo

Abstract

Measurement of serum (1-->3)-beta-D-Glucan (BG) is an aid in the diagnosis of fungemia and deep-seated mycoses, including invasive aspergillosis (IA). BG is present in the cell wall of most pathogenic fungi (including Pneumocystis jiroveci) in significant amounts with some notable exceptions such as Cryptococcus neoformans and Zygomycetes. Commercially available assays can detect serum BG concentrations as low as 1 pg/mL. Published validation studies have included patients with IA and other invasive fungal diseases (IFD). BG detection appears to be more sensitive than galactomannan detection in patients with IA, but BG's intrinsic lack of mycological specificity requires the integration of clinical, radiological, and microbiological data for proper interpretation. BG assay test characteristics can be used, for example, to exclude IA in some clinical scenarios, to increase the certainty of IA in the presence of an isolated positive galactomannan result or when testing follows initiation of antifungal treatment. BG may be falsely elevated in the serum in the absence of IFD in patients undergoing hemodialysis with cellulose membranes, in patients treated with immunoglobulin, albumin, or other blood products filtered through cellul...Continue Reading

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