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- Title
Diagnostic performance of immunohistochemistry for the aspergillosis and mucormycosis.
- Authors
Choi, Sungim; Song, Joon Seon; Kim, Ji Yeun; Cha, Hye Hee; Yun, Ji Hyppun; Park, Jung Wan; Jung, Kyung Hwa; Jo, Kyeong Min; Jung, Jiwon; Kim, Min Jae; Chong, Yong Pil; Park, Young Soo; Lee, Sang‐Oh; Choi, Sang‐Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung‐Han
- Abstract
Summary: Objective: To investigate the accuracy of immunohistochemistry (IHC) tests for distinguishing between mucormycosis and aspergillosis and compare the clinical characteristics of mucormycosis patients according to galactomannan (GM) results. Methods: We evaluated diagnostic performance of IHC test with tissue sections of patients with culture‐proven invasive fungal infection. In addition, we conducted PCR assay with tissue sections of mucormycosis patients with positive GM results to evaluate the possibility of co‐infection. Results: In culture‐proven mucormycosis (n = 13) and aspergillosis (n = 20), the sensitivity and specificity of IHC test were both 100% for mucormycosis and 85% and 100%, respectively, for aspergillosis. Among the 53 patients who met the modified criteria for proven mucormycosis and had GM assay results, 24 (45%) were positive. Compared with those with negative GM results (n = 29), mucormycosis patients with positive GM results had significantly higher incidence of gastrointestinal tract infections (6/24 [25%] vs 0/29 [0%], P = .006) and were more likely to be histomorphologically diagnosed as aspergillosis (7/24 [29%] vs 2/29 [7%], P = .06). PCR assay amplified both Aspergillus‐ and Mucorales‐specific DNA in 6 of these 24 cases. Conclusions: Immunohistochemistry tests seem useful for compensating for the limitations of histomorphologic diagnosis in distinguishing between mucormycosis and aspergillosis. Some proven mucormycosis patients with positive GM results had histopathology consistent with aspergillosis and gastrointestinal mucormycosis. In addition, about one quarter of these patients revealed the evidence of co‐infection with aspergillosis by PCR assay.
- Subjects
DIAGNOSTIC immunohistochemistry; MUCORMYCOSIS; MYCOSES; GASTROINTESTINAL system; MIXED infections
- Publication
Mycoses, 2019, Vol 62, Issue 11, p1006
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.12994