Bronchoalveolar lavage fluid cytology in culture-documented invasive pulmonary aspergillosis in patients with hematologic diseases: analysis of 67 episodes.

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Bronchoalveolar lavage fluid cytology in culture-documented invasive pulmonary aspergillosis in patients with hematologic diseases: analysis of 67 episodes.

J Clin Microbiol. 2018 Jul 18;:

Authors: Fernández-Cruz A, Magira E, Heo ST, Evans S, Tarrand J, Kontoyiannis DP

Abstract
There is a paucity of studies on the yield of Gomori-methenamine-silver (GMS) stain in BAL cytology and its comparison with fluorescent dyes for the diagnosis of IPA in patients with hematologic malignancies. To that end, we analysed the yield of direct fungal visualization in bronchoalveloar lavage (BAL) cytology by GMS stain in a series of culture-positive IPA in 67 patients with hematologic malignancies, and compared it with direct examination with Calcofluor White™ and BAL galactomannan when available. GMS stain in (BAL) was positive in 42% of 67 cases and revealed co-infections in seven. In contrast, only 2/67 (3.6%) of BAL samples were positive by the direct smear fluorescent dye Calcofluor White™ stain. Positive GMS was significantly more frequent in IPA with cavitary lesions and IPA caused by >1 Aspergillus species, but the proportion of positive cytology among Aspergillus species was not different.

PMID: 30021823 [PubMed – as supplied by publisher]

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