Help me Educate the Educaters = read this it will make sense!!

[Guest guest]

Since this is the place I'm going to = the only place covered by Medicaid & they

have (A LOW SUCCESS RATE) NO IDEA of this information, nor the mold diet (I.E.:

SUGAR = bad), etc.; could you please send new info like this over to them in

care of their Director? They need all the help they can get & I know how Dr.'s

roll their eyes at patients like me trying to educate them.

Many thanks, your saving lives!!

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This is to inform of different tests that are used. This test however is not

specific to what type of mold, fungi, or yeast is causing the infection.

Currently this test is only approved for use in transplant patients. It is still

an adjunct to prove that infection has occurred as with IA of Candida.

Two new antigen-based tests show promise and could prove useful for

immunocompromised patients. Early diagnosis and therapy is critical to the

management of patients with invasive fungal disease (IFD). Although diagnosis

has been based on culture or microscopy, antigen-based assays to detect (1

3)-â-D- glucan (BG) and Aspergillus galactomannan recently became available.

Both rely on identification of polysaccharides associated with the cell wall of

fungal pathogens. Now, two research groups have examined the performance and

usefulness of these assays in patients at risk for IFD. Koo and colleagues

retrospectively reviewed the results of 1308 serum BG assays performed for 871

patients. For patients tested more than once, the results of the first BG test

were used. A BG level 80 pg/mL had a sensitivity of 64% and a specificity of

84% for a diagnosis of IFD within 1 week. Sensitivity was 71% and specificity

was 81% for such a diagnosis by the end of hospitalization. Albumin, intravenous

immunoglobulin, and hemodialysis independently increased BG levels. When

patients with these factors were excluded from analysis, the specificity of the

test increased slightly, but the sensitivity remained unchanged. Maertens and

colleagues examined the use of the Platelia Aspergillus galactomannan assay on

bronchoalveolar lavage (BAL) fluid from patients hospitalized for hematologic

disorders. (One of the authors has received support from the assay maker.) Among

99 BAL samples, the mean optical density for the assay was 4.3 for 58 patients

with proven or probable invasive pulmonary aspergillosis (IPA) compared with 0.6

for 41 controls without this diagnosis. At an optical density 1.0, sensitivity

was 91% and specificity was 88% for diagnosing IPA. For culture or microscopy,

the sensitivity was only 74%. Comment: These reports indicate the value of

newer, antigen-based techniques for diagnosing IFD. Because neither assay

depends on host immune response, both are useful for immunocompromised patients.

Although caveats remain regarding their interpretation, these tests are

important additions to our armamentarium. -- Neil M. Ampel, MD Published in

Journal Watch Infectious Diseases November 18, 2009 Citation(s): Maertens J et

al. Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive

pulmonary aspergillosis in patients with hematologic diseases. Clin Infect Dis

2009 Dec 1; 49:1688. ·

Medline abstract (Free) Koo S et al. Diagnostic performance of the (1

3)-â-D-glucan assay for invasive fungal disease. Clin Infect Dis 2009 Dec 1;

49:1650. · Medline abstract (Free)

More options Nov 19, 1:36 pm