Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Clinical and Chemical Pathology

Aim of the work: To assess the utility of 1, 3 beta D- glucan in diagnosis of invasive pulmonary aspergillosis in comparison with other conventional methods. Material and Methods: This study was cohort study included 100 patients with respiratory infection not responding to antibiotics, immunocompromised state and radiological findings suggesting invasive fungal infection. BAL samples were subjected to direct microscopic examination, fungal and bacterial culture, galactomannan and beta D- glucan. Results: Beta {u2013}D- glucan had sensitivity of 42% compared to fungal culture 74% and galactomannan 83.7%, while sensitivity of direct microscopic examination was 36%. There was slight agreement between beta- D- glucan and fungal culture (K= 0116) and between BDG and galactomannan (K= 0.194). Invasive pulmonary aspergillosis was related to prolonged use of corticosteroids, diabetes, neutropenia and prolonged courses of antibiotics. Conclusion: The combined use of BDG and GM with conventional culture and direct microscopic examination for the diagnosis of invasive fungal infection in high risk patients increases the diagnostic accuracy and allows early detection and early treatment (total accuracy of two tests 87.5)

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