Cerebrospinal Fluid (1,3)-Beta- d -Glucan Testing Is Useful in Diagnosis of Coccidioidal Meningitis
| Autor: | Demosthenes Pappagianis, Karl V. Clemons, Malcolm A. Finkelman, David A. Stevens, Yonglong Zhang, Marife Martinez |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
0301 basic medicine Microbiology (medical) Meningitides Pathology medicine.medical_specialty beta-Glucans 030106 microbiology Mycology Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Antigen Predictive Value of Tests Humans Medicine 030212 general & internal medicine False Negative Reactions Cerebrospinal Fluid Coccidioidomycosis biology business.industry medicine.disease Meningitis Fungal 1 3-Beta-glucan synthase ROC Curve Predictive value of tests biology.protein Coccidioidal meningitis Proteoglycans Antibody business Meningitis |
| Zdroj: | Journal of Clinical Microbiology. 54:2707-2710 |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.01224-16 |
| Popis: | Diagnosing coccidioidal meningitis (CM) can be problematic owing to its infrequency and/or a delay in the positivity of a cerebrospinal fluid (CSF) culture or CSF antibody, particularly if the primary coccidioidal infection is unrecognized. We tested 37 CSF specimens, 26 from patients with confirmed CM and 11 from patients with suspected microbial meningitis without fungal diagnosis, for (1,3)-beta-glucan (BG). BG in CM CSF specimens ranged from 18 to 3,300 pg/ml and in controls ranged from 103 pg/ml were CM. The one false-negative specimen was from a patient with a pseudosyrinx, without inflammatory evidence of meningitis activity. Serial samples from some patients were positive at ≤8 years, indicating no loss of positivity with chronicity. Samples stored frozen since 2000 included those with 2 of the 3 highest values, indicating that fresh samples not required. A previous study indicated serum sensitivities of 53% in acute, 50% in resolved, and 83% in disseminated and meningeal coccidioidomycosis. Three studies of other fungal meningitides ranged from 86 to 1,524 pg/ml CSF, with 37 controls of |
| Databáze: | OpenAIRE |
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