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Memórias do Instituto Oswaldo Cruz

Print version ISSN 0074-0276On-line version ISSN 1678-8060

Mem. Inst. Oswaldo Cruz vol.83 no.3 Rio de Janeiro July./Sept. 1988

http://dx.doi.org/10.1590/S0074-02761988000300013 

Aspergillus fumigatus fungus ball in hospitalized patients with chronic pulmonary disease: usefulness of double immunodiffusion test as a screening procedure

M. F. Ferreira-da-Cruz1 

B. Wanke2 

C. Pirmez2 

B. Galvão-Castro2 

Hospital Evandro Chagas, Rio de Janeiro, Brasil

Instituto Oswaldo Cruz, Departamento de Imunologia, Rio de Janeiro, Brasil

ABSTRACT

Double immunodiffusion (DID) was used as a screening test for the diagnosis of aspergillosis. Three hundred and fifty patients were tested, all of them referred from a specialized chest disease hospital and without a definitive etiological diagnosis. When DID was positive addtional information such as clinical history and radiographic findings were requested and also surgical specimens were obtained whenever possible. Specific precipitin hamds for Aspergillus fumigatus antigen were found in 29 (8.3%) of 350 patients sera. Nineteen (65.5%) of the 29 patients with positive serology were recognized as having a fungus ball by X-rays signs in 17 or by pathological examination in 2 or by both in 8 patients. This two-year prospective study has shown that pulmonary aspergillos is a considerable problem among patiens admitted to a Chest Diseases Hospital, especially in those with pulmonary cavities or bronchiectasis.

Key words: aspergillosis; fungus ball; double immunodiffusion

RESUMO

Trezentos e cinquenta pacientes sintomáticos respiratórios admitidos no Hospial Raphael de Paula Souza, sem diagnóstico etiológico definitivo, foram triados pela técnica de imunodifusão dupla (IDD) para aspergilose. Quando a IDD foi positiva, informações adicionais como histórico e exames radiológicos foram requisitados e, quando possível, espécimes clínicos foram processados para exames micológicos e histopatológicos. Linhas de precipitação específicas para o antígeno de A. fumigatus foram encontradas em 29(8,3%) dos 350 soros de pacientes testados. Dezenove (65,5% dos 29 pacientes cm sorologia positiva foram reconhecidos como tendo boa fúngica pelos achados radiológicos em dois ou por ambos em oito pacientes. Este estudo prospectivo de dois anos mostrou que aspergilose pulmonar é um problema considerável entre pacientes admitidos em um hospital para sintomáticos respiratórios, especialmente aqueles com cavidades pulmonares ou bronquiectasias.

Palavras-Chave: aspergilose; bola fúngica; imunodifusão dupla

 

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