Muhammed Ceesay - Academia.edu (original) (raw)
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Background Invasive fungal disease (IFD) is difficult to diagnose. For clinical trials the Europe... more Background Invasive fungal disease (IFD) is difficult to diagnose. For clinical trials the European Organisation for Research in Treatment of Cancer (EORTC) and the Mycology Study Group (MSG) criteria are useful but there are few data on their value in clinical practice. The aims of this study were to: (1) investigate the incidence and risk factors of IFD; (2) assess the utility of galactomannan (GM), β-D glucan (BDG), the UK consensus fungal PCR, and lateral flow device (LFD) assays together with the safety and feasibility of biopsy; (3) assess the role of cytokines in the diagnosis and prognosis of IFD; (4) establish the prevalence of baseline CT abnormalities, and assess diagnostic CT features and spectrum of radiological signs. Methods Patients (N=203) were recruited prospectively and followed for a median (range) of 556 (12-730) days after chemotherapy or haematopoietic stem cell transplantation. Chest CT, Karnofsky score (KS), serum GM, and cytokine profiles were performed at baseline; during admission twice-weekly GM assays were performed on all patients. BDG, serum and whole blood consensus PCR, and LFD assays were performed on a selection of samples from different IFD categories. Neutropenic sepsis refractory to antimicrobials for ≥4 days triggered diagnostic CT and biopsy where feasible. All patients were on
Background Invasive fungal disease (IFD) is difficult to diagnose. For clinical trials the Europe... more Background Invasive fungal disease (IFD) is difficult to diagnose. For clinical trials the European Organisation for Research in Treatment of Cancer (EORTC) and the Mycology Study Group (MSG) criteria are useful but there are few data on their value in clinical practice. The aims of this study were to: (1) investigate the incidence and risk factors of IFD; (2) assess the utility of galactomannan (GM), β-D glucan (BDG), the UK consensus fungal PCR, and lateral flow device (LFD) assays together with the safety and feasibility of biopsy; (3) assess the role of cytokines in the diagnosis and prognosis of IFD; (4) establish the prevalence of baseline CT abnormalities, and assess diagnostic CT features and spectrum of radiological signs. Methods Patients (N=203) were recruited prospectively and followed for a median (range) of 556 (12-730) days after chemotherapy or haematopoietic stem cell transplantation. Chest CT, Karnofsky score (KS), serum GM, and cytokine profiles were performed at baseline; during admission twice-weekly GM assays were performed on all patients. BDG, serum and whole blood consensus PCR, and LFD assays were performed on a selection of samples from different IFD categories. Neutropenic sepsis refractory to antimicrobials for ≥4 days triggered diagnostic CT and biopsy where feasible. All patients were on