Cryptococcosis laboratory tests: Difference between revisions

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==Overview==
==Overview==
There are no specific laboratory findings associated with [[cryptococcal infection]], but  it can be diagnosed through [[Growth medium|culture]], [[CSF]] microscopy, or by [[Cryptococcosis|cryptococcal]] [[antigen]] (CrAg) detection.


==Laboratory Findings==
==Laboratory Findings==
Cryptococcal disease can be diagnosed through culture, CSF microscopy, or by cryptococcal antigen (CrAg) detection. In patients with HIV-related cryptococcal meningitis, 55% of blood cultures and 95% of CSF cultures are positive and visible colonies can be detected within 7 days. The opening pressure in the CSF may be elevated, with pressures ≥25 cm H2O occurring in 60% to 80% of patients.
There are no specific laboratory findings associated with [[Cryptococcosis|cryptococcal infection]], but it can be diagnosed through:<ref name="aids">Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf Accessed on December 31, 2015.</ref><ref name="pmid26897067">{{cite journal| author=Maziarz EK, Perfect JR| title=Cryptococcosis. | journal=Infect Dis Clin North Am | year= 2016 | volume= 30 | issue= 1 | pages= 179-206 | pmid=26897067 | doi=10.1016/j.idc.2015.10.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26897067  }} </ref><ref name="pmid26515783">{{cite journal| author=El Fane M, Badaoui L, Ouladlahsen A, Sodqi M, Marih L, Chakib A et al.| title=[Cryptococcosis during HIV infection]. | journal=J Mycol Med | year= 2015 | volume= 25 | issue= 4 | pages= 257-62 | pmid=26515783 | doi=10.1016/j.mycmed.2015.09.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26515783  }} </ref>
====Culture====
 
*The gold standard for diagnosing cryptococcal infection; culture is traditionally identify Cryptococcus from human body samples.
#[[Culture media|Culture]]
*Blood cultures may be positive in heavy infections.
#[[CSF]] microscopy  
====Microscopy====
#[[Cryptococcal infection|Cryptococcal]] [[antigen]] (CrAg) detection
*India Ink can be performed on CSF to quickly visualize Cryptococcus cells under a microscope; however, it can have limited sensitivity.
 
*Many laboratories in the United States no longer perform this test.
*In patients with [[HIV]]-related [[Cryptococcal Meningitis|cryptococcal meningitis]], 55% of [[blood culture]]<nowiki/>s and 95% of [[CSF]] cultures are positive and visible colonies can be detected within 7 days.  
*Histopathology for detection of narrow-based budding yeasts in tissue can also be used.
*The opening pressure in the [[CSF]] may be elevated, with pressures ≥25 cm H2O in 60% to 80% of patients.
====Antigen detection====
* Antigen detection can be used on CSF or serum for detection of early, asymptomatic cryptococcal infection in HIV-infected patients.
* It has a higher sensitivity than microscopy or culture.
* CSF CrAg is usually positive in patients with cryptococcal meningoencephalitis. Serum CrAg is usually positive in both meningeal and non-meningeal infection and may be present weeks to months before symptom onset.
* A positive serum CrAg should prompt a lumbar puncture to rule out meningeal disease.
*Techniques used include:
:*Latex agglutination (LA)
:*Enzyme immunoassay (EIA)
:*Lateral flow assay (LFA)


==References==
==References==
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[[Category:Fungal diseases]]
[[Category:Fungal diseases]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Pulmonology]]
[[Category:Neurology]]
[[Category:Dermatology]]

Latest revision as of 21:10, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D.; Yazan Daaboul, M.D.

Overview

There are no specific laboratory findings associated with cryptococcal infection, but it can be diagnosed through culture, CSF microscopy, or by cryptococcal antigen (CrAg) detection.

Laboratory Findings

There are no specific laboratory findings associated with cryptococcal infection, but it can be diagnosed through:[1][2][3]

  1. Culture
  2. CSF microscopy
  3. Cryptococcal antigen (CrAg) detection
  • In patients with HIV-related cryptococcal meningitis, 55% of blood cultures and 95% of CSF cultures are positive and visible colonies can be detected within 7 days.
  • The opening pressure in the CSF may be elevated, with pressures ≥25 cm H2O in 60% to 80% of patients.

References

  1. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf Accessed on December 31, 2015.
  2. Maziarz EK, Perfect JR (2016). "Cryptococcosis". Infect Dis Clin North Am. 30 (1): 179–206. doi:10.1016/j.idc.2015.10.006. PMID 26897067.
  3. El Fane M, Badaoui L, Ouladlahsen A, Sodqi M, Marih L, Chakib A; et al. (2015). "[Cryptococcosis during HIV infection]". J Mycol Med. 25 (4): 257–62. doi:10.1016/j.mycmed.2015.09.008. PMID 26515783.