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Journal of Clinical Microbiology, April 1999, p. 1186-1189, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Aspergillus Meningitis: Diagnosis by Non-Culture-Based Microbiological Methods and Management

Paul E. Verweij,1,* Kees Brinkman,2,dagger Herbert P. H. Kremer,3 Bart-Jan Kullberg,2 and Jacques F. G. M. Meis1

Departments of Medical Microbiology,1 Internal Medicine,2 and Neurology,3 University Hospital Nijmegen, Nijmegen, The Netherlands

Received 31 August 1998/Returned for modification 15 October 1998/Accepted 30 December 1998

The performance of antibody detection, antigen detection, and Aspergillus genus-specific PCR for diagnosing Aspergillus meningitis was investigated with 26 cerebrospinal fluid (CSF) samples obtained from a single patient with proven infection caused by Aspergillus fumigatus. Immunoglobulin G antibodies directed against Aspergillus were not detected by enzyme-linked immunosorbent assay in CSF or serum. The antigen galactomannan was detected in the CSF 45 days before a culture became positive, and Aspergillus DNA was detected 4 days prior to culture. Decline of the galactomannan antigen titer in the CSF during treatment with intravenous and intraventricular amphotericin B and intravenous voriconazole corresponded with the clinical response to treatment.

* Corresponding author. Mailing address: Department of Medical Microbiology, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Phone: 31-24-3614356. Fax: 31-24-3540216. E-mail: p.verweij{at}mmb.azn.nl.

dagger Present address: Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.

Journal of Clinical Microbiology, April 1999, p. 1186-1189, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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