Lheureux Olivier, Montesinos Isabel, Taton Olivier, Antoine Martine, Preiser Jean-Charles, Nortier Joelle, Creteur Jacques, Jacobs Frederique, Grimaldi David
Department of Intensive Care, CUB - Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, 1070 Brussels, Belgium.
Department of Microbiology, CUB - Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.
JMM Case Rep. 2017 Sep 18;4(9):e005116. doi: 10.1099/jmmcr.0.005116. eCollection 2017 Sep.
Diagnosis of invasive aspergillosis is challenging and the gold standard for definite diagnosis remains histopathological tissue examination. However, invasive procedures such as lung biopsy are often not feasible in critically ill patients. The detection of fungal cell wall components like galactomannan in broncho-alveolar lavage remains a key component of the diagnostic procedure. False-positive of the galactomannan assay is not frequent. We report a case of positive galactomannan in broncho-alveolar lavage fluid after enteral nutrition aspiration without signs of invasive aspergillosis. Galactomannan was positive in the enteral nutrition solution. Physicians should be aware of this previously unrecognized cause of false-positive galactomannan in broncho-alveolar fluid which can result in unnecessary treatments.
侵袭性曲霉病的诊断具有挑战性，明确诊断的金标准仍是组织病理学检查。然而，对于重症患者，诸如肺活检等侵入性操作往往不可行。检测支气管肺泡灌洗中的半乳甘露聚糖等真菌细胞壁成分仍是诊断过程的关键部分。半乳甘露聚糖检测的假阳性并不常见。我们报告一例肠内营养误吸后支气管肺泡灌洗液半乳甘露聚糖阳性但无侵袭性曲霉病迹象的病例。肠内营养溶液中的半乳甘露聚糖呈阳性。医生应意识到这种先前未被认识的导致支气管肺泡液半乳甘露聚糖假阳性的原因，这可能导致不必要的治疗。
