Although Aspergillus spp may cause chorioretinitis, these organisms are rarely found in the aqueous fluid. Thus, of the testing procedures listed, anterior chamber aqueocentesis would be the least appropriate test in this patient.
In suspected cases of aspergillosis, the Aspergillus spp antigen EIA test (MiraVista Diagnostics) can be performed on either urine or serum and has good sensitivity and specificity, although false-positive results can occur with related mycotic infections and supplementation of certain drugs or IV fluids.5
Urine culture is an inexpensive and specific test for diagnosing disseminated aspergillosis, but its sensitivity may vary depending on the organ involved.6
Lymph node cytology can have excellent specificity for fungal lymphadenitis when organisms are seen, but sensitivity is hampered by low burden of infection or lack of identification of fungal hyphae, which might require use of special stains.6
Vertebral body cytology can have excellent specificity for fungal diskospondylitis when organisms are seen, but sensitivity is hampered by low burden of infection or lack of identification of fungal hyphae, which (like for lymph node cytology) might require use of special stains. In addition, ultrasound-guided vertebral body aspiration, which is recommended over blind aspiration, can be technically challenging.6