Abstract
The diagnosis of central nervous system (CNS) histoplasmosis is often difficult. Although cerebrospinal fluid (CSF) (1,3)-β-d-glucan (BDG) is available as a biological marker for the diagnosis of fungal meningitis, there are limited data on its use for the diagnosis of Histoplasma meningitis. We evaluated CSF BDG detection, using the Fungitell assay, in patients with CNS histoplasmosis and controls. A total of 47 cases and 153 controls were identified. The control group included 13 patients with a CNS fungal infection other than histoplasmosis. Forty-nine percent of patients with CNS histoplasmosis and 43.8% of controls were immunocompromised. The median CSF BDG level was 85 pg/ml for cases, compared to <31 pg/ml for all controls (P < 0.05) and 82 pg/ml for controls with other causes of fungal meningitis (P = 0.27). The sensitivity for detection of BDG in CSF was 53.2%, whereas the specificity was 86.9% versus all controls and 46% versus other CNS fungal infections. CSF BDG levels of ≥80 pg/ml are neither sensitive nor specific to support a diagnosis of Histoplasma meningitis.
References
Jul 1, 1984·Journal of the History of Medicine and Allied Sciences·F B Rogers
Sep 16, 2005·Biometrical Journal. Biometrische Zeitschrift·Ronen FlussBenjamin Reiser
Feb 13, 2009·The Tohoku Journal of Experimental Medicine·Hajime KanamoriMitsuo Kaku
May 22, 2010·Journal of Medical Microbiology·Zdenek RacilJiri Mayer
Feb 9, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Malgorzata MikulskaClaudio Viscoli
Dec 18, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anastasia P LitvintsevaBenjamin J Park
Sep 18, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jennifer L LyonsIvana Vodopivec
Nov 8, 2014·Journal of Clinical Microbiology·Jennifer L LyonsSean X Zhang
Dec 30, 2014·Journal of Clinical Microbiology·Anurag N MalaniApril C Pettit
Mar 4, 2015·Open Forum Infectious Diseases·Joshua RheinDavid R Boulware
Sep 26, 2015·Journal of the Pediatric Infectious Diseases Society·Christine M SalvatoreThomas J Walsh
Aug 26, 2016·Journal of Clinical Microbiology·David A StevensMarife Martinez
Feb 6, 2017·The Journal of Biological Chemistry·Andrew L GarfootChad A Rappleye
Oct 12, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Karen C BlochL Joseph Wheat
Citations
Mar 29, 2019·Current Opinion in Infectious Diseases·Karen C Bloch, Samuel S Bailin
Jan 31, 2020·Journal of Clinical Microbiology·Christian DavisNathan C Bahr
Apr 10, 2020·Biomarkers in Medicine·Victoria PoplinNathan C Bahr
Jul 28, 2019·Journal of Fungi·James Riddell, L Joseph Wheat
Apr 8, 2020·HIV/AIDS : Research and Palliative Care·Thein MyintL Joseph Wheat
Jan 3, 2021·Journal of Clinical Immunology·Owen DeanPeter R Williamson