Serologic immunodiagnosis of of invasive aspergillosis.

Two sensitive methods, counterimmunoelectrophoresis (CIE) and enzyme-linked immunosorbent assay (ELISA), for detecting antibodies to Aspergilus were used to study serial specimens from patients with histologically proven invasive aspergillosis for measurement of conversion from negative to positive immunoprecipitin reactions and changes in ELISA titers during immunosuppression. Sera from 12 granulocytopenic patients without invasive aspergillosis served as controls. Positive CIE reactions were demonstrated in 70% of patients with clinically suspected aspergillosis. In addition to a greater sensitivity (80%) of ELISA, the serial determination of antibody response by Elisa allowed for separation of seropositive patients into two groups. A serial rise in ELISA titer appeared to correlate with histologically documented recovery from infection, whereas those with declining or persistently intermediate titers were found to have disseminated aspergillosis at autopsy. Thus, serial antibody determination by ELISA was valuable as both a diagnostic and prognostic tool.