Performance of Aspergillus PCR in cerebrospinal fluid for the diagnosis of cerebral aspergillosis

Abstract : Objectives: cerebral aspergillosis is a rare but often fatal form of invasive aspergillosis that remains difficult to diagnose. The literature has shown the value of Aspergillus PCR in blood-derived samples for the diagnosis of invasive aspergillosis but provides far less information for cerebrospinal fluid (CSF) in cerebral aspergillosis. Here, we evaluated the usefulness of an Aspergillus PCR assay performed on CSF for the diagnosis of cerebral aspergillosis. Methods: this retrospective study involved 72 patients with suspected cerebral aspergillosis for a total of 88 CSF samples in whom CSF Aspergillus PCR was performed. Results: seventeen patients had proven/probable invasive aspergillosis according to the European Organisation for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria, including twelve cases of proven/probable cerebral aspergillosis. AspergillusPCR in CSF was positive in nine of the twelve patients with cerebral aspergillosis, i.e. 75% sensitivity. In contrast, CSF culture was positive for Aspergillus in only two patients. In the non cerebral aspergillosis group (60 patients), PCR was positive in one patient, i.e., 98.3% specificity. In this particular population of high-risk patients with suspicion of cerebral aspergillosis, the disease incidence was 16.7%. Therefore, the positive and negative predictive values of PCR were 90% and 95.2% respectively. Conclusion: the results of this study indicate that Aspergillus PCR in CSF is an interesting tool that may eliminate the need for cerebral biopsy in patients with suspected cerebral aspergillosis.
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Clinical Microbiology and Infection, Wiley, 2017, 〈10.1016/j.cmi.2017.06.012〉
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Dernière modification le : mercredi 21 mars 2018 - 18:57:52
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Sébastien Imbert, Jean-Yves Brossas, Martine Palous, Isabelle Joly, Isabelle Meyer, et al.. Performance of Aspergillus PCR in cerebrospinal fluid for the diagnosis of cerebral aspergillosis. Clinical Microbiology and Infection, Wiley, 2017, 〈10.1016/j.cmi.2017.06.012〉. 〈hal-01548945〉

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