Abstract

Early diagnosis of invasive aspergillosis (IA) is facilitated by detection of galactomannan (GM) in serum and bronchoalveolar lavage fluid (BALF) using an enzyme-linked immunosorbent assay (ELISA). Although accurate, false positive results have been reported with these tests in numerous contexts. We report for the first time the occurrence of false positive GM ELISA due to nocardiosis, initially in a clinical sample of BALF from a patient with pulmonary nocardiosis, and subsequently corroborated by in vitro reactivity of 26% of tested isolates. Since patients at risk for IA are also at risk for nocardiosis, this finding has important clinical implications.

Lay Summary

Early diagnosis of aspergillosis has been facilitated by the routine use of antibody-based detection of galactomannan in various bodily fluids. We report for the first time the occurrence of false positive results of this assay in the context of nocardiosis.

中文翻译：

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肺诺卡菌病假阳性半乳甘露聚糖抗原检测

摘要

使用酶联免疫吸附试验 (ELISA) 检测血清和支气管肺泡灌洗液 (BALF) 中的半乳甘露聚糖 (GM) 有助于侵袭性曲霉病 (IA) 的早期诊断。尽管这些测试在许多情况下都报告了准确的假阳性结果。我们首次报告了由诺卡菌病引起的假阳性 GM ELISA 的发生，最初是在来自肺诺卡菌病患者的 BALF 临床样本中，随后由26% 的测试分离株的体外反应性证实。由于有患 IA 风险的患者也有患诺卡菌病的风险，因此这一发现具有重要的临床意义。

总结

通过常规使用基于抗体的检测各种体液中的半乳甘露聚糖，促进了曲霉病的早期诊断。我们首次报告了在诺卡菌病背景下该测定的假阳性结果的发生。