Premium
Diagnostic performance of immunohistochemistry for the aspergillosis and mucormycosis
Author(s) -
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 SangOh,
Choi SangHo,
Kim Yang Soo,
Woo Jun Hee,
Kim SungHan
Publication year - 2019
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12994
Subject(s) - mucormycosis , aspergillosis , mucorales , galactomannan , immunohistochemistry , mycosis , histopathology , pathology , aspergillus , medicine , incidence (geometry) , biology , gastroenterology , immunology , microbiology and biotechnology , physics , optics
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.