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Journal of Clinical Microbiology
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Mycology

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
David W. Warnock, Editor
Thein Myint
Division of Infectious Diseases, Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA
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Felicia C. Chow
Department of Neurology, University of California, San Francisco, San Francisco, California, USA
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Karen C. Bloch
Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Luke Raymond-Guillen
Division of Infectious Diseases, Department of Internal Medicine, Indiana University, Indianapolis, Indiana, USA
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Thomas E. Davis
Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana, USA
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Patty W. Wright
Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Laila Woc-Colburn
Division of Infectious Diseases, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA
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Raed N. Khairy
Sparks Clinic, Fort Smith, Arkansas, USA
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Alan C. Street
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Tomotaka Yamamoto
Department of Neurology, University of Tokyo Hospital, Tokyo, Japan
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Amanda Albers
MiraVista Diagnostics, Indianapolis, Indiana, USA
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L. Joseph Wheat
MiraVista Diagnostics, Indianapolis, Indiana, USA
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Chadi A. Hage
Division of Pulmonary and Critical Care Medicine, Thoracic Transplantation Program, Indiana University-School of Medicine, Indianapolis, Indiana, USA
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David W. Warnock
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DOI: 10.1128/JCM.00663-18
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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.

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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
Journal of Clinical Microbiology Sep 2018, 56 (10) e00663-18; DOI: 10.1128/JCM.00663-18

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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
Journal of Clinical Microbiology Sep 2018, 56 (10) e00663-18; DOI: 10.1128/JCM.00663-18
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KEYWORDS

(1,3)-β-d-glucan
cerebrospinal fluid
Histoplasma
meningitis

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