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A diagnostic-driven approach allows early treatment (in neutropenic patients with or without fever)1-4

A combination of diagnostic assessments is recommended:5

  • Routine galactomannan (GM) monitoring every 3-4 days
  • Appropriate clinical and microbiological evaluation
  • High-resolution computed tomography (CT) imaging

CT Section of the lung with halo sign in a patient with haematological malignancy 


Adapted from Greene RE et al, 20076

A diagnostic-driven approach has the potential to help you save lives6

  • Routine GM screening is shown to lead to the early initiation of anti-fungal therapy4
  • Initiating appropriate treatment on the basis of CT patterns has been shown to save lives6
  • Increased survival was observed in patients with pulmonary invasive aspergillosis who presented with a halo sign versus those with other imaging findings at week 12: 71% vs 53%, respectively (p<0.01)6

*Analysis of chest CT findings at presentation from a large series (n=235) of patients with invasive pulmonary aspergillosis (IPA), to assess the prevalence of a "halo sign" and to evaluate the clinical utility of this imaging finding for early identification and treatment of IPA.6

Vfend® (voriconazole) is not indicated for the empirical treatment of invasive aspergillosis.

Example of a diagnostic-driven anti-fungal therapy integrated care pathway7

Full preview Diagnostic-driven anti-fungal therapy integrated care pathway

Check response on day7. If no response to treatment, further diagnosis is required; if patient responds to treatment, consider the duration of therapy, "step down" therapy, and outpatient follow up.

†Multidisciplinary team input important at this stage.

Diagnostic Assay Procedures

Introduced by Malcolm Richardson
Director – Mycology Reference Centre, Wythenshawe Hospital , Manchester
Honorary Professor – Medical Mycology, University of Manchester

‘The use of non-culture based diagnostic tests for the diagnosis of invasive aspergillosis’.

Watch the video

Pulmonary Diagnostics

Introduced by Anna Sharman
Consultant Thoracic Radiologist, 
University Hospital of South Manchester


‘Radiology Techniques in diagnosing invasive pulmonary aspergillosis’.

Watch the video

IFD, invasive fungal disease; MD, invasive mold disease; PCR, polymerase chain reaction


  1. Rogers TR, et al. Br J Haematol. 2011; 153(6): 681-97.
  2. Freemantle N, et al. J Antimicrob Chemother. 2011; 66 (Supp 1): i25-35.
  3. De Pauw BE & Viscoli C. J Antimicrob Chemother. 2011; 66 (Supp 1): i55-8.
  4. Maertens J, et al. Clin Infect Dis. 2005; 41 (9): 1242-50.
  5. Marchetti O et al. Bone Marrow Transplant. 2012; 47(6): 846-54.
  6. Greene RE, et al. Clin Infect Dis. 2007; 44(3): 379-9.
  7. Agrawal S, et al. J Antimicrob Chemother. 2011; 66 (Supp 1): i45-53.