To the Editor—We appreciate the comments by Rijnders and Slobbe [1]. Regular testing for the detection of serum or plasma galactomannan (GM) has become increasingly popular for the early diagnosis of invasive aspergillosis (IA), especially in patients with prolonged profound neutropenia and in allogeneic stem cell transplant recipients. However, the excellent performance characteristics of serum GM testing that are usually seen in these particular patient groups cannot be demonstrated in nonneutropenic hematology patients [2] and in nonhematology patients, including intensive care unit patients [3]. This limitation calls for other microbiological tests, including analysis of bronchoalveolar lavage (BAL) fluid, to establish the diagnosis of IA. As stated by Rijnders and Slobbe, the question remains whether GM testing on BAL fluid results in any additional diagnostic yield in comparison with serum GM testing. In our study [4], paired BAL fluid and serum GM test results (taken on the same day and before antifungal treatment was given) were available from 10 neutropenic and 19 nonneutropenic patients with proven IA (Table 1). Using a cutoff index of 1.0, the sensitivity of GM detection in BAL fluid was 100% in neutropenic patients and 94.7% in nonneutropenic patients (P > .99); however, using a cutoff index of 0.5, the sensitivity of serum GM testing was significantly better in neutropenic versus nonneutropenic patients (90% vs 36.8%; P = .008). Overall, determination of GM levels in BAL fluid seems to have a higher sensitivity than serum testing.