Rapid Diagnosis of Cryptococcal Meningitis by Use of Lateral Flow Assay on Cerebrospinal Fluid Samples: Influence of the High-Dose “Hook” Effect

Lourens, Adré; Jarvis, Joseph N; Meintjes, Graeme; Samuel, Catherine M

doi:10.1128/jcm.01683-14

Cited by 51 publications

(48 citation statements)

References 20 publications

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“…A more recent multisite diagnostic study in Uganda and South Africa found the CrAg LFA to have a sensitivity and specificity of 99.3% and 99.1% in CSF (6). In a study published in South Africa, the sensitivity of the CrAg LFA in CSF was reported as only 91% (11); however, when samples with a suspected high organism load underwent a 1:2 dilution prior to testing, sensitivity improved to 100%, an incongruity attributed to the “hook effect”, whereby a high cryptococcal antigen load interferes with the antigen-antibody complex of the assay producing false negative results.…”

Section: Introductionmentioning

confidence: 99%

Cryptococcal Meningitis: Diagnosis and Management Update

2015

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Recent advances in the diagnosis and management of cryptococcal meningitis are promising and have been improving long-term survival. Point of care testing has made diagnosing cryptococcal meningitis rapid, practical, and affordable. Targeted screening and treatment programs for cryptococcal antigenemia are a cost effective method for reducing early mortality on antiretroviral therapy (ART). Optimal initial management with amphotericin and flucytosine improves survival against alternative therapies, although amphotericin is difficult to administer and flucytosine is not available in middle or low income countries, where cryptococcal meningitis is most prevalent. Controlling increased intracranial pressure with serial therapeutic lumbar punctures has a proven survival benefit. Delaying ART initiation for 4 weeks after the diagnosis of cryptococcal meningitis is associated with improved survival. Fortunately, new approaches have been leading the way toward improving care for cryptococcal meningitis patients. New trials utilizing different combinations of antifungal therapy are reviewed, and we summarize the efficacy of different regimens.

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Section: Introductionmentioning

confidence: 99%

Cryptococcal Meningitis: Diagnosis and Management Update

2015

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“…The reasons for exclusion as shown in Figure 1. Finally, we included 15 quali ed articles [9,11,[13][14][15][16][17][18][19][20][21][22][23][24][25] .…”

Section: Search Resultsmentioning

confidence: 99%

Evaluation of lateral flow immunochromatographic assay for diagnostic accuracy of cryptococcosis

Xie

Lin

Dong

et al. 2020

Preprint

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Background: Cryptococcus is a conditional pathogenic fungus causing cryptococcosis, which is one of the most serious fungal diseases faced by humans. Lateral flow immunochromatographic assay (LFA) is successfully applied to the rapid detection of cryptococcal antigens. Methods: Studies were retrieved systematically from the Embase, PubMed, Web of Science, and Cochrane Library before July 2019. The quality of the studies was assessed by Review Manager 5.0 based on the Quality Assessment of Diagnostic Accuracy Study guidelines. The extracted data from the included studies were analyzed by Meta-DiSc 1.4. Stata 12.0 software was used to detect the publication bias. Results: A total of 15 articles with 31 fourfold tables were adopted by inclusion and exclusion criteria. The merged sensitivity and specificity in serum were 0.98 and 0.98, respectively, and those in the cerebrospinal fluid were 0.99 and 0.99, respectively. Conclusions: Compared to the urine and other samples, LFA in serum and cerebrospinal fluid is favorable evidence for the diagnosis of cryptococcosis with high specificity and sensitivity.

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“…18 studies were excluded after screening the abstracts. After full-text review, we included 15 qualified articles [9][10][12][13][14][15][16][17][18][19][20][21][22][23][24] .…”

Section: Search Resultsmentioning

confidence: 99%

Evaluation of lateral flow immunochromatographic assay for diagnostic accuracy of cryptococcosis

Xie

Lin

Dong

et al. 2019

Preprint

View full text Add to dashboard Cite

Background : Cryptococcus is a conditional pathogenic fungus causing cryptococcosis, which is one of the most serious fungal diseases faced by humans. Lateral flow immunochromatographic assay (LFA) is successfully applied to the rapid detection of cryptococcal antigens. Methods : Studies were retrieved systematically from the Embase, PubMed, Web of Science, and Cochrane Library before July 2019. The quality of the studies was assessed by Review Manager 5.0 based on the Quality Assessment of Diagnostic Accuracy Study guidelines. The extracted data from the included studies were analyzed by Meta-DiSc 1.4. Stata 12.0 software was used to detect the publication bias. Results : A total of 15 articles with 31 fourfold tables were adopted by inclusion and exclusion criteria. The merged sensitivity and specificity in serum were 0.98 and 0.98, respectively, and those in the cerebrospinal fluid were 0.99 and 0.99, respectively. Conclusions : Compared to the urine and other samples, LFA in serum and cerebrospinal fluid is favorable evidence for the diagnosis of cryptococcosis with high specificity and sensitivity.

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Rapid Diagnosis of Cryptococcal Meningitis by Use of Lateral Flow Assay on Cerebrospinal Fluid Samples: Influence of the High-Dose “Hook” Effect

Cited by 51 publications

References 20 publications

Cryptococcal Meningitis: Diagnosis and Management Update

Cryptococcal Meningitis: Diagnosis and Management Update

Evaluation of lateral flow immunochromatographic assay for diagnostic accuracy of cryptococcosis

Evaluation of lateral flow immunochromatographic assay for diagnostic accuracy of cryptococcosis

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