Nihon Ishinkin Gakkai Zasshi
Online ISSN : 2434-5237
Print ISSN : 2434-5229
Challenges in Implementing Antifungal Stewardship Programs Mediated by Laboratory Testing at Osaka Metropolitan University Hospital
Makoto NikiHiroshi Kakeya
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2023 Volume 64 Issue 2 Pages 59-66

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Abstract
 Pulmonary aspergillosis is a refractory infectious disease that occurs in patients with impaired immunity or pulmonary underlying diseases. It is roughly categorized into invasive pulmonary aspergillosis and chronic pulmonary aspergillosis depending on their clinical course or underlying diseases. Diagnosing aspergillosis requires a review of background information or radiological findings. As the sensitivity of fungal culture is low, bronchoscopy must be performed to obtain specimen from the site of infection for fungal culture or pathological examination. However, bronchoscopy is occasionally avoided if the patient has poor general conditions. Hence, a better supportive diagnostic method is needed. Galactomannan antigen has good accuracy for the diagnosis of invasive pulmonary aspergillosis, but not for chronic pulmonary aspergillosis. Although the Aspergillus precipitating antibody test has a relatively good sensitivity and specificity for the diagnosis of chronic pulmonary aspergillosis, it is not covered by the Japanese medical insurance system. Approval of Aspergillus IgG EIA antibody tests or the development of new diagnostic methods for pulmonary aspergillosis is necessary.
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© 2023 The Japanese Society for Medical Mycology
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