serum galactomannan assay in invasive aspergillosis

 Q: The serum galactomannan assay has both diagnostic as well as prognostic value in invasive aspergillosis? 

 A) True 

B) False 

Answer: A

Patients who show no improvement towards normalization of serum galactomannan assays tend to die despite all treatments in invasive aspergillosis. Usually, serum galactomannan assay a week after an initial positive assay is a good indicator of treatment outcome. 

To note, this is true only for the serum galactomannan assay and not for bronchoalveolar lavage (BAL), where it's diagnostic as well as prognostic value is still debated and largely depends on its Optimum Density (OD) index.

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References:

1. de Heer K, Gerritsen MG, Visser CE, Leeflang MM. Galactomannan detection in broncho-alveolar lavage fluid for invasive aspergillosis in immunocompromised patients. Cochrane Database Syst Rev 2019; 5:CD012399.

2. Miceli MH, Grazziutti ML, Woods G, et al. Strong correlation between serum aspergillus galactomannan index and outcome of aspergillosis in patients with hematological cancer: clinical and research implications. Clin Infect Dis 2008; 46:1412. 

3. Koo S, Bryar JM, Baden LR, Marty FM. Prognostic features of galactomannan antigenemia in galactomannan-positive invasive aspergillosis. J Clin Microbiol 2010; 48:1255. 

4. Fisher CE, Stevens AM, Leisenring W, et al. The serum galactomannan index predicts mortality in hematopoietic stem cell transplant recipients with invasive aspergillosis. Clin Infect Dis 2013; 57:1001.