Detection of (1,3)-β-D-Glucan in cerebrospinal fluid in histoplasma meningitis

Thein Myint, Felicia C. Chow, Karen C. Bloch, Luke Raymond-Guillen, Thomas E. Davis, Patty W. Wright, Laila Woc-Colburn, Raed N. Khairy, Alan C. Street, Tomotaka Yamamoto, Amanda Albers, L. Joseph Wheat, Chadi A. Hage

Research output: Contribution to journalArticle

5 Scopus citations

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.

Original languageEnglish (US)
Article numbere00663
JournalJournal of clinical microbiology
Volume56
Issue number10
DOIs
StatePublished - Oct 2018

Keywords

  • (1,3)-β-D-glucan
  • Cerebrospinal fluid
  • Histoplasma
  • Meningitis

ASJC Scopus subject areas

  • Microbiology (medical)

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    Myint, T., Chow, F. C., Bloch, K. C., Raymond-Guillen, L., Davis, T. E., Wright, P. W., Woc-Colburn, L., Khairy, R. N., Street, A. C., Yamamoto, T., Albers, A., Wheat, L. J., & Hage, C. A. (2018). Detection of (1,3)-β-D-Glucan in cerebrospinal fluid in histoplasma meningitis. Journal of clinical microbiology, 56(10), [e00663]. https://doi.org/10.1128/JCM.00663-18