ASPERGILLUS INFECTIONS - PROBLEMS IN DIAGNOSIS AND TREATMENT

Invasive aspergillosis is a common infection in patients who are immun ocompromised, particularly in oncology patients, patients receiving ot her immunosuppressive therapy, bone marrow transplant patients, and HI V-infected patients. The diagnosis of invasive aspergillosis is diffic ult in the absence of tissue biopsy and histologic confirmation. There fore, the need for and progress in recent advances in the development of highly sensitive and specific serodiagnostic tests for the early di agnosis of invasive aspergillosis have been reviewed. Anti-Aspergillus antibody detection lacks the utility to lead to early diagnosis of in vasive aspergillosis. However, sensitive methods that detect significa nt amounts of Aspergillus antigen in body fluids, primarily serum, of high risk patients are currently being evaluated and may provide a non invasive early diagnostic test that is both sensitive and specific. Ou r recent results with an inhibition enzyme-linked immunosorbent assay, which detects small but significant amounts of Aspergillus antigen in serum, in 35 patients with invasive aspergillosis are discussed. Also , current antifungal agents with anti-Aspergillus activity that have t he potential for use as therapy or prophylaxis are briefly reviewed.