Diagnosis of Histoplasmosis by Antigen Detection in BAL Fluid
| Autor: | Chadi A. Hage, L. Joseph Wheat, John Witt, Kenneth S. Knox, Thomas E. Davis, Lindsey Egan, DeAnna Fuller |
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| Rok vydání: | 2010 |
| Předmět: |
Pulmonary and Respiratory Medicine
Pathology medicine.medical_specialty Antigens Fungal Histoplasma Enzyme-Linked Immunosorbent Assay Critical Care and Intensive Care Medicine Sensitivity and Specificity Blastomycosis Histoplasmosis Serology Diagnosis Differential Antigen Bronchoscopy medicine Humans Mycosis biology medicine.diagnostic_test business.industry Reproducibility of Results respiratory system medicine.disease biology.organism_classification respiratory tract diseases Cytopathology Immunoassay Immunology Cardiology and Cardiovascular Medicine business Bronchoalveolar Lavage Fluid |
| Zdroj: | Chest. 137:623-628 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.09-1702 |
| Popis: | Background Detection of antigen in BAL is useful for diagnosis of histoplasmosis. The MVista Histoplasma antigen enzyme immunoassay has been modified to permit quantification. The purpose of this study is to compare the sensitivity of the quantitative antigen detection assay with cytopathology and culture of BAL specimens. Methods BAL from patients with histoplasmosis who were evaluated at the Indiana University Medical Center and controls without histoplasmosis were studied. BAL fluid was tested in the quantitative Histoplasma antigen assay. Results Antigen was detected in the BAL in 93.5% of patients with histoplasmosis, 80% with blastomycosis, and 0% of controls with nonfungal infections. Antigen was detected in the urine of 79% and serum in 65% of patients with histoplasmosis. Cytopathology was positive in 48% and culture in 48% of patients with histoplasmosis, and 40% and 60% of patients with blastomycosis, respectively. Serology was positive in 65%. Combining BAL antigen detection and BAL cytopathology, both methods for rapid diagnosis, the sensitivity was 96.8% in histoplasmosis and 80% in blastomycosis. Conclusions Detection of antigen in BAL complements antigen detection in serum and urine as an objective diagnostic test for histoplasmosis. |
| Databáze: | OpenAIRE |
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