scholarly journals Diagnostic Value of Latex Agglutination in Cryptococcal Meningitis

2009 ◽  
Vol 1 (02) ◽  
pp. 067-068 ◽  
Author(s):  
RM Saldanha Dominic ◽  
H V Prashanth ◽  
Shalini Shenoy ◽  
Shrikala Baliga
Keyword(s):  
Early Diagnosis ◽  
Cryptococcus Neoformans ◽  
Cryptococcal Meningitis ◽  
Diagnostic Value ◽  
Latex Agglutination ◽  
Antigen Detection ◽  
Specific Method ◽  
Cryptococcal Antigen ◽  
India Ink ◽  
Efficient Test

ABSTRACT Background: Cryptococcus neoformans is the most common fungal pathogen to infect the central nervous system, and an effective diagnostic method is therefore necessary for the early diagnosis of cryptococcal meningitis. Aim: The efficacy of India ink preparation, cerebrospinal fluid (CSF) culture and CSF cryptococcal antigen detection by the latex agglutination test for diagnosis of cryptococcal meningitis are compared to determine the most efficient test. Materials and Methods: Two hundred CSF samples from human immunodeficiency virus - positive patients suspected to be suffering from meningitis were screened for Cryptococcus neoformans. Results: Latex agglutination for cryptococcal antigen detection was found to be more sensitive compared to India ink staining and CSF culture. Conclusion: Antigen detection by latex agglutination proved to be both sensitive and specific method for the diagnosis of cryptococcal meningitis. Rapid, early diagnosis of infection by detection of cryptococcal antigen by latex agglutination may alter the prognosis for these patients.

Evaluation of Clinical Profile, Diagnostic Tests, And Prognosis of Cryptococcal Meningitis in HIV Infected Patients in Western India

2020 ◽  
Vol 20 ◽  
Author(s):  
Deepak Kumar ◽  
Suresh Bishnoi ◽  
Durga Shankar Meena ◽  
Gopal Krishana Bohra ◽  
Naresh Midha ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Clinical Features ◽  
Cryptococcal Meningitis ◽  
Fatal Outcome ◽  
Clinical Profile ◽  
Western India ◽  
Antigen Test ◽  
Cryptococcal Antigen ◽  
India Ink ◽  
Csf Examination

Background: Cryptococcal meningitis is a dreaded complication in HIV infected patients. It was associated with high mortality and morbidity before the advent of Highly Active Anti-Retroviral Therapy. A study was planned in our institute to evaluate the clinical profile, laboratory findings, and prognostic factors for survival in these patients. Settings and Design: A prospective hospital-based observational study, conducted in the Department of Medicine at a tertiary care centre in western Rajasthan. Method and Material: HIV infected patients presenting with clinical features of meningitis, and positive CSF culture for Cryptococcus were included in our study. All cases underwent detailed clinical history, physical examinations and relevant laboratory investigations including CD4 count and CSF examination. Results: 48 HIV infected cryptococcal meningitis patients were analysed, and the most common presenting clinical features were headache (85.42%), and fever (72.92%), followed by neck stiffness (62.50%). CSF examination was also done for Cryptococcal Antigen test which was reactive in all cases (100%), and India ink staining was positive in 43 cases (89.58%). Significant fatal outcome was associated with patients presenting with altered sensorium, loss of consciousness, cranial nerve palsy and CD4 cell count of less than 100. Similarly, on laboratory and imaging diagnosis, cryptococcal antigen test (>3+reactive), fundus examination (papilloedema) and abnormal CT/MRI brain imaging were associated with poor survival. Conclusion: Cryptococcal meningitis is a potentially lethal infection in immunocompromised individuals and should be diagnosed early with high clinical suspicion as around 10% of the cases may not be detected on India ink staining and a large proportion (75%) of cases may have normal imaging at initial evaluation. Early diagnosis, watchful eye on prognostic factors and treatment is vital to improve outcome in these patients.

scholarly journals Kriptokokal meningitis: Aspek klinis dan diagnosis laboratorium

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Efrida Efrida ◽  
Desi Ekawati
Keyword(s):  
Enzyme Immunoassay ◽  
Cryptococcus Neoformans ◽  
Opportunistic Infection ◽  
Cryptococcal Meningitis ◽  
Clinical Symptoms ◽  
Cell Mediated Immunity ◽  
India Ink ◽  
Aids Pandemic ◽  
Direct Microscopic Examination ◽  
Common Opportunistic Infection

Abstrak Kriptokokosis merupakan infeksi yang disebabkan oleh jamur Cryptococcus neoformans, infeksi ini secara luas ditemukan di dunia dan umumya dialami oleh penderita dengan sistem imun yang rendah. Munculan klinis terutama adalah meningitis dan meningoensefalitis yang dikenal dengan kriptokokal meningitis. Sejalan dengan infeksi HIV yang menjadi pandemi, kriptokokosis sebagai infeksi oportunistik juga semakin berkembang di dunia. Kriptokokal meningitis merupakan infeksi oportunistik kedua paling umum yang terkait dengan AIDS di Afrika dan Asia Selatan dengan kejadian kriptokokosis 15%-30% ditemukan pada pasien dengan AIDS. Tanpa pengobatan dengan antifungal yang spesifik, mortalitas dilaporkan 100% dalam dua minggu setelah munculan klinis kriptokokosis dengan meningoensefalitis pada populasi terinfeksi HIV. Di Indonesia, sebelum pandemi AIDS kasus kriptokokosis jarang dilaporkan. Sejak tahun 2004, seiring dengan pertambahan pasien terinfeksi HIV, Departemen Parasitologi FKUI mencatat peningkatan insidensi kriptokokal meningitis pada penderita AIDS yaitu sebesar 21,9%. Faktor yang terkait dengan virulensi Cryptococcus neoformans adalah adanya kapsul polisakarida, produksi melanin dan sifat thermotolerance. Imunitas yang dimediasi oleh sel memiliki peranan penting dalam pertahanan pejamu terhadap Cryptococcus. Pemeriksaan laboratorium penunjang untuk diagnosis adalah pemeriksaan mikroskopis langsung menggunakan tinta India, deteksi antigen, metode enzyme immunoassay, kultur, dan metode molekular. Kata kunci: kriptokokal meningitis, Cryptococcus neoformans,infeksi oportunistik Abstract Cryptococcosis is an infection caused by Cryptococcus neoformans, that is widely found worldwide and generally experienced by patients with immunodeficiency. Meningitis and meningoencephalitis is the major clinical symptoms in cryptococcal meningitis. Coincide with the pandemic of HIV infection, cryptococcosis as an opportunistic infection is also growing in the world. Cryptococcal meningitis is the second most common opportunistic infection associated with AIDS in Africa and South Asia with the incidence of cryptococcosis is 15% -30% found in patients with AIDS. Without specific antifungal treatment, 100% mortality reported within two weeks after clinical cryptococcosis with meningoencephalitis in HIV-infected population. In Indonesia, before the AIDS pandemic, cryptococcosis cases are rarely reported. Since 2004, by the increasing HIV-infected patients. Department of Parasitology Faculty of Medicine, Indonesian University also reported an increase incidence of cryptococcal meningitis in AIDS patients that is about 21.9%. Associated factors with virulence of Cryptococcus neoformans is the polysaccharide capsule, melanin production and thermotolerance. Cell-mediated immunity has an important role in host defense against Cryptococcus. Laboratory tests for cryptococcosis diagnosis is direct microscopic examination using India ink, antigen detection, enzyme immunoassay, culture, and molecular methods. Keywords: cryptococcal meningitis, Cryptococcus neoformans, opportunistic infection

scholarly journals Detection of Cryptococcus neoformans capsular polysaccharide antigen in asymptomatic HIV-infected patients

1995 ◽  
Vol 37 (5) ◽  
pp. 385-389 ◽  
Author(s):  
R. Negroni ◽  
C. Cendoya ◽  
A.I. Arechavala ◽  
A.M. Robles ◽  
M. Bianchi ◽  
...  
Keyword(s):  
Cryptococcus Neoformans ◽  
Capsular Polysaccharide ◽  
Detection System ◽  
Latex Agglutination ◽  
Antigen Detection ◽  
Hiv Positive ◽  
Cd4 Cells ◽  
Serum Samples ◽  
Capsular Antigen ◽  
Asymptomatic Hiv

Serum samples from 242 HIV-positive persons were studied for the detection of capsular polysaccha-ride antigen of Cryptococcus neoformans; 193 of these patients presented less than 300 CD4+ cells/µl of blood and 49 patients had more than 300 CD4+ cells/µl. None of them had symptoms or signs characteristic of cryptococcosis. The capsular antigen of C. neofarmans was detected by latex agglutination technique with pronase pre-treatment (IMMY, Crypto-Latex Antigen Detection System, Immunomycologics Inc., OK, USA); in 61% of the samples, ELISA technique was also used (Premier, Cryptococcal Antigen, Meridian Diagnostic Inc., Cincinatti, Oh, USA). The comparative study of both methods showed that the results obtained were similar in 96.9% of the cases. The capsular antigen was detected in 13 out of 193 (6.7%) patients with less than 300 CD4+ cells/µl. Cryptococcosis was confirmed mycologically in 3 of these 13 cases (23%) by the isolation of C. neoformans in CSF or blood cultures. Three patients, who had presented negative results of both tests for capsular antigen, suffered disseminated cryptococcosis 4 to 8 months later. The predictive diagnostic value of capsular antigen detection of C. neoformans seems tobe low and we believe that it should not be done routinely in asymptomatic HIV-positive persons.

scholarly journals Cryptococcal Glucoxylomannan Does Not Exhibit Cross-Reactivity in the MVista Histoplasma Antigen Enzyme Immunoassay

2007 ◽  
Vol 15 (2) ◽  
pp. 392-393 ◽  
Author(s):  
David Zhuang ◽  
Chadi Hage ◽  
Magdia De Jesus ◽  
Emily Hackett ◽  
Michelle Durkin ◽  
...  
Keyword(s):  
Enzyme Immunoassay ◽  
Cryptococcus Neoformans ◽  
Histoplasma Capsulatum ◽  
Cross Reactivity ◽  
Latex Agglutination ◽  
Cross Reaction ◽  
Cryptococcal Antigen

ABSTRACT The potential for cross-reaction between Cryptococcus neoformans and Histoplasma capsulatum in antigen assays was evaluated. We tested patient samples, spleens from infected mice, and purified polysaccharides in the MVista Histoplasma antigen enzyme immunoassay and cryptococcal antigen latex agglutination system for cross-reactivity, and none was observed.

scholarly journals The Evaluation of Some Biomarkers According to Rheumatoid Factor in Early Diagnosis of Rheumatoid Arthritis from Iraqi Patients

2020 ◽  
pp. 2196-2203
Author(s):  
Hind Jaber Hassoon ◽  
Walaa Esmail Jasim ◽  
Ahmed Abdul Hassan Abbas
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Diagnostic Value ◽  
Latex Agglutination ◽  
Control Group ◽  
Peptide Antigens ◽  
Healthy Control ◽  
Heterogeneous Nuclear Ribonucleoproteins ◽  
Serological Data ◽  
Inflammatory Autoimmune Disease

 Rheumatoid arthritis (RA) was a chronic inflammatory autoimmune disease for long-term that primarily affects small joints and leads to chronic inflammation in synovial. The aimed of the study to identify the relationships among some serological markers (antibodies to citrullinated protein/peptide antigens (ACPAs), anti-mutated citrullinated vimentin (anti-MCV), anti-carbamylated protein (Anti-Carp), anti- heterogeneous nuclear ribonucleoproteins (anti-hnRNP) and Glucose-6-phosphate isomerase (GPI)) and early diagnosis of RA. The study involved (60) Patients of newly diagnosis with RA that divided in to two subgroups (30 RF positive and 30 RF negative) groups and 30 subjects as healthy control group. The serological data from serum concentration of (ACPAs, Anti-MCV, Anti-Carp, Anti-hnRNP, G6PI) estimated by ELISA methods, RF estimated by latex agglutination kits. The results revealed that ACPAs, Anti-MCV, Anti-Carp, Anti-hnRNP, G6PI having a statistical significants at the mean±SD titer different between the two RF groups, a higher value among the refractory RA patients in comparison with the control group. Also effectively distinguishing RA patients groups for RF+ve and RF-ve with showed the sensitivity and specificity of, ACPAs (90.8% , 94.1%, and  88.2%, 86.6%); anti-MCV (66.7% , 33.0% and 70.0%, 70.2%); anti-CarP (76.7% , 90.0% and 93.3%, 78.5%); anti-hnRNP (74.9% , 61.9% and 71.4%, 70.9%) and GPI (77.3% , 76.7% and 84.4%, 80.1%) respectively. This study confirm the importance of measuring multiple serum biomarkers and their com­binations with high diagnostic value for RA and provide sup­port for the early diagnosis of RA.

scholarly journals 253. Evaluation of a Cryptococcal Antigen Lateral Flow Assay and the Burden of Cryptococcal Disease: A Cohort Study at Grady Memorial Hospital in Atlanta, Georgia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S141-S142 ◽  
Author(s):  
Kristin Harrington ◽  
Yun Wang ◽  
Paulina Rebolledo ◽  
Zhiyong Liu ◽  
Qianting Yang ◽  
...  
Keyword(s):  
The United States ◽  
Latex Agglutination ◽  
Lateral Flow ◽  
Lateral Flow Assay ◽  
High Rate ◽  
Memorial Hospital ◽  
Cryptococcal Antigen ◽  
India Ink ◽  
Cryptococcal Disease ◽  
Positive Serum

Abstract Background While Cryptococcus neoformans is a major cause of morbidity and mortality among HIV-infected persons worldwide, there is scarce recent data on disease prevalence in the United States, including in Southeastern states, where HIV rates are high. We sought to determine the prevalence of cryptococcal disease and compare the performance of a cryptococcal antigen (CrAg) lateral flow assay (LFA) vs. latex agglutination (LA) test. Methods All patients from Grady Memorial Hospital in Atlanta, Georgia who had a serum or cerebrospinal fluid (CSF) sample sent for CrAg LA testing as part of routine management from November 2017 to July 2018 were included. The LFA was performed on all samples by research staff; results were not available to clinicians. Rates of disease and agreement between the LA test and LFA were calculated. Results Among 467 patients, 570 LA tests were performed; 417 on serum and 153 on CSF (87 patients with multiple tests performed). Mean age was 44 years, and most were male (n = 322, 69%). Most patients had HIV (n = 371, 79%); median CD4 count was 73 cells/mm3 and 77% were not receiving ART. Among HIV-infected individuals, testing was performed equally in the inpatient and outpatient setting. Cryptococcal testing was done in 53 persons without apparent risk factors. Thirty-three (7%) patients had a positive serum or CSF test. Five (1%) patients had both a positive serum and CSF LA test and LFA. While the overall agreement between the LA test and LFA was substantial to high for CSF (κ = 0.71) and serum (κ = 0.93), respectively, there were important discrepancies. Four patients with a negative serum LA test had a positive serum LFA. Five patients had false-positive CSF LA tests, determined by negative CSF LFA testing, India ink, and CSF and fungal cultures. All were treated with amphotericin and flucytosine with one patient experiencing a severe anaphylactic reaction to amphotericin. Conclusion We found a moderately high rate of cryptococcal disease and important discrepancies between the LA test and LFA. The LFA appeared to be more sensitive for cryptococcemia and more specific for meningitis. Clinical implications of these findings include earlier detection and treatment of cryptococcemia, and averting unnecessary treatment of meningitis with costly medications associated with high rates of adverse events. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence of cryptococcal meningitis in a tertiary care centre.

2020 ◽  
Vol 7 (3) ◽  
pp. 15-21
Author(s):  
Ashish Bajaj ◽  
Bibhati Mishra ◽  
Poonam Loomba ◽  
Archana Thakur ◽  
Abha Sharma ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cryptococcal Meningitis ◽  
Tertiary Care ◽  
Cns Infection ◽  
Fungal Culture ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cryptococcal Antigen ◽  
India Ink ◽  
Appropriate Treatment

Background: Cryptococcal meningitis has emerged as an important opportunistic central nervous system (CNS) infection in Human Immunodeficiency Virus (HIV) positive patients. It is associated with a high mortality rate. Hence early diagnosis is necessary to start appropriate treatment. Cryptococcosis is generally found in association with acquired immunodeficiency syndrome (AIDS) although it has been reported to cause disease in HIV-seronegative patients also. Objective:Prevalence of Cryptococcal meningitis in a tertiary care centre. Material & Methods: A total of 93 Cerebrospinal fluid samples from suspected cases of fungal meningitis were received in the microbiology department of GB Pant Hospital(GIPMER) from January to June 2018. Samples were subjected to direct microscopy- wet mount, India ink preparation and Gram stain, Cryptococcal antigen detection(Latex agglutination), and Fungal culture. In vitro susceptibility of Cryptococcus isolates to Fluconazole, Voriconazole, 5- Flucytosine and Amphotericin B was performed using standard broth microdilution method. Results: Out of 93 CSF samples, 6 were positive for India ink preparation and showed gram positive budding yeast cells by gram staining. All 6 samples were positive for the cryptococcal antigen test and fungal culture. Five were identified as C. neoformans and one C. gatti. All strains were susceptible to Amphotericin B. Four patients were HIV reactive and succumbed to the diseaseduring treatment. Two patients were found to be coinfected with Hepatitis B virus. Ashish Bajaj1, Bibhabati Mishra2, Poonam S Loomba2, Archana Thakur3, Abha Sharma4, Prachala G Rathod1, Madhusmita Das1, Ashna Bhasin1 1Senior Resident, 2Director Professor, 3Director Professor & Head, 4Assistant Professor, Department of Microbiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India ABSTRACT Cryptococcal meningitis has emerged as an important opportunistic central nervous system (CNS) infection in immunosuppressed patients.It is associated with a high mortality rate(>30%) in immunosuppressed patients especially those infected with HIV, hence early diagnosis is necessary to start appropriate treatment. Prevalence of cryptococcal infection is increasing in developing nations including India as per some recent studies.(1) Conclusion: Index of suspicion of Cryptococcus infection as a possible cause of meningitis must be considered in chronic meningitis cases. Microscopy (India ink preparation) may be used as a cheap and rapid diagnostic tool.

scholarly journals Role of Polymerase Chain reaction (PCR) amplifying conserved 5.8S and ITS regions of the cryptococcal DNA in the diagnosis of Cryptococcal meningitis

2015 ◽  
Vol 4 (2) ◽  
pp. 31-35
Author(s):  
Sujata Dharmshale ◽  
Renu Bharadwaj
Keyword(s):  
Polymerase Chain Reaction ◽  
Predictive Value ◽  
Cryptococcal Meningitis ◽  
Latex Agglutination ◽  
Antigen Detection ◽  
High Morbidity ◽  
Care Hospital ◽  
Chain Reaction ◽  
Reliable Technique ◽  
Polymerase Chain

Cryptococcus neoformans, a common fungal pathogen of the central nervous system, results in high morbidity and mortality, unless diagnosed early and specific treatment instituted. The efficacy of the currently available tests for diagnosis (i.e. microscopy and latex agglutination test) are limited. The purpose of the present study was to evaluate a polymerase chain reaction (PCR) test for the diagnosis of cryptococcal meningitis. This cross-sectional prospective study was carried out in a large tertiary care hospital, Pune, India during April 2009 to February 2012. A total of 111 cerebrospinal fluid (CSF) samples were collected from patients with suspected cryptococcal meningitis. All samples were processed for microscopy, culture, antigen detection by Cryptococcal Antigen Latex Agglutination System (CALAS) and PCR using specific primers CN4/CN5. The PCR was evaluated using culture as the gold standard and results compared with those obtained by microscopy and latex agglutination. In the present study 55(49.54%) had laboratory confirmed cryptococcal meningitis (either smear/CALAS/culture/PCR positive). The sensitivity of PCR, antigen detection test and microscopy was 100%, 89.19% and 78.4% respectively while the specificity of these tests was 82.43%, 85.14% & 90% respectively. The positive predictive value of the PCR was 74% and the negative predictive value was 100%. The PCR technique proved to be a rapid and reliable technique for the early diagnosis of cryptococcal meningitis.South East Asia Journal of Public Health Vol.4(2) 2014: 31-35

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