Examination of a Chinese-made cryptococcal glucuronoxylomannan antigen test in serum and bronchoalveolar lavage fluid for diagnosing pulmonary cryptococcosis in HIV-negative patients

Li, Zhengtu; Wang, Mingdie; Zeng, Peiying; Chen, Zhaoming; Zhan, Yangqing; Li, Shaoqiang; Ye, Lin; Cheng, Jing; Ye, Feng

doi:10.1016/j.jmii.2021.05.002

Cited by 4 publications

(1 citation statement)

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“…The assay has high sensitivity and specificity (>95% and 100%, respectively, in CSF and sera of patients with HIV) [51][52][53]. In patients with pulmonary disease and without HIV, sensitivity and specificity of serum CrAg remain high (97% and 95% respectively in one study) [59]. The possibility for a prozone effect can be offset by running the assay at a 5-or 10-fold dilution alongside the neat specimen [60], and a positive result should always be titred to endpoint using serial dilutions.…”

Section: Cryptococcal Antigen Testingmentioning

confidence: 99%

Pulmonary Cryptococcosis

Howard‐Jones

Sparks

Pham

et al. 2022

JoF

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Pulmonary cryptococcosis describes an invasive lung mycosis caused by Cryptococcus neoformans or Cryptococcus gattii complex. It is often a high-consequence disease in both immunocompromised and immunocompetent populations, and may be misdiagnosed as pulmonary malignancy, leading to a delay in therapy. Epidemiology follows that of cryptococcal meningoencephalitis, with C. gattii infection more common in certain geographic regions. Diagnostic tools include histopathology, microscopy and culture, and the detection of cryptococcal polysaccharide antigen or Cryptococcus-derived nucleic acids. All patients with lung cryptococcosis should have a lumbar puncture and cerebral imaging to exclude central nervous system disease. Radiology is key, both as an adjunct to laboratory testing and as the initial means of detection in asymptomatic patients or those with non-specific symptoms. Pulmonary cryptococcomas (single or multiple) may also be associated with disseminated disease and/or cryptococcal meningitis, requiring prolonged treatment regimens. Optimal management for severe disease requires extended induction (amphotericin B and flucytosine) and consolidation therapy (fluconazole) with close clinical monitoring. Susceptibility testing is of value for epidemiology and in regions where relatively high minimum inhibitory concentrations to azoles (particularly fluconazole) have been noted. Novel diagnostic tools and therapeutic agents promise to improve the detection and treatment of cryptococcosis, particularly in low-income settings where the disease burden is high.

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