Meije et al. report in their letter 'Silent and prolonged Aspergillus DNAemia in oncohematological patients receiving antifungal prophylaxis: a new phenomenon with clinical implications' that Aspergillus PCR was a relevant and useful diagnostic tool in early detection of invasive aspergillosis (IA). This is in contrast to what we reported recently.1 Meije et al. report on six patients with IA for whom Aspergillus fumigatus PCR tests were persistently positive for several weeks before galactomannan Ag test turned positive and clinical symptoms developed. In our study, we followed patients undergoing reduced-intensity conditioning allogeneic hematopoietic SCT with weekly fungal PCR during the first 100 days post transplantation. We found that a single positive PCR test was not associated with IA. This is consistent with the findings of several other authors, including a study by Meije et al. that reported a low positive predictive value using a single positive PCR test.2 Regarding the association between multiple positive PCR tests and proven and probable IA that Meije et al. report in their letter, we could not draw any conclusion in our study because of low numbers.
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