Background Elderly people who suffer from chronic pulmonary aspergillosis (CPA) develop debilitating fever and exhaustion. It is often hard to confirm the diagnosis because invasive diagnostic procedures are difficult to perform. Materials and Methods We reviewed medical records of eleven patients with CPA (80±8 years of age, F2/M9) that we had encountered for the past six years in our hospital. In parallel with the serological testing including the GM antigen and the precipitating antibody, Aspergillus -LFD using monoclonal antibody JF5 was also tested for its utility. Results (1) Of eleven patients in the present study, ten showed radiological cavitary changes with fungus ball in half of them, and the other one did bronchiectasis. (2) Of seven patients who had the tuberculosis sequela, five were positive for the precipitating antibody against Aspergillus fumigatus and six were positive for the GM antigen, respectively. (3) Of the remaining four patients without the past history of tuberculosis, three had been treated with oral corticosteroids, and the other one patient developed Aspergillus lung abscess after lung cancer surgery. The GM antigen was positive in three patients and the precipitating antibody was positive in one patient. (4) Of eight patients' serum samples which were available, six samples were positive (3+; 1 sample, 2+; 2 samples, and 1+; 3 samples) and the other two were negative for LFD. (5) Serum beta-D-glucan values were negative in ten patients. Discussion The Aspergillus antigen and antibody detection testing combined with LFD was useful for enabling early diagnosis and treatment of CPA, and then contributed to the improvement of patients' QOL.
Kobayashi et al. (Mon,) studied this question.