Fungal infections of the nose and paranasal sinuses are classified into
invasive and non invasive types. Rapid detection and identification of causative fungi is
crucial for effective treatment and avoidance of complications. Objectives: To evaluate
diagnostic outcome of ELISA detection of galactomannan (GM) in sinus lavage aspirate
as a rapid minimally invasive diagnostic test for Aspergillus spp. sinus infection in
comparison to fungus DNA detection by nested PCR. Methodology: 95 chronic
rhinosinusitis (CRS) patients had manifestations since ≥12 weeks despite of medical
therapy were clinically and radiologically evaluated and underwent sinus lavage.
Lavage aspirate was used for microbiological examination, PCR testing for Aspergillus
DNA and ELISA detection of GM. Results: PCR defined Aspergillus DNA in 56 samples,
culture defined 53 positive samples for Aspergillus spp. infection and ELISA detected
GM antigen in 49 samples. In comparison to PCR result, sensitivity, specificity, positive
predictive value (PPV) and negative predictive value (NPV) and accuracy rates of
culture were 73.2%, 69.3%, 77.4%, 64.3% and 71.6% while ELISA detected GM antigen
were 84.6%, 88.4%, 89.8%, 82.6% and 86.3%, respectively. ELISA results significantly
correlated with results of culture and PCR with a positive significant correlation
between PCR and culture results. ROC curve analysis defined ELISA detection of GM as
more significant predictor for result of culture (AUC =0.792, p |
