Cryptococcosis other diagnostic studies: Difference between revisions

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Revision as of 15:43, 5 June 2017

Other Diagnostic studies

India ink or fungal wet mount of CSF will demonstrate a (budding yeast).
Mucicarmine stain provides specific staining of the polysaccharide cell wall.
Antigen detection in CSF is useful for the diagnosis of cryptococcal meningitis.

Fungal meningitis may be differentiated from other causes of meningitis by cerebrospinal fluid examination as shown below:^[1]^[2]^[3]^[4]^[5]


Cerebrospinal fluid level	Normal level	Bacterial meningitis^[4]	Viral meningitis^[4]	Fungal meningitis	Tuberculous meningitis^[6]	Malignant meningitis^[1]
Cells/ul	< 5	>300	10-1000	10-500	50-500	>4
Cells	Lymphocyte:Monocyte 7:3	Granulocyte > Lymphocyte	Lymphocyte > Granulocyte	Lympho.>Granulocyte	Lymphocytes	Lymphocytes
Total protein (mg/dl)	45-60	Typically 100-500	Normal or slightly high	High	Typically 100-200	>50
Glucose ratio (CSF/plasma)^[2]	> 0.5	< 0.3	> 0.6	<0.3	< 0.5	<0.5
Lactate (mmols/l)^[3]	< 2.1	> 2.1	< 2.1	>3.2	> 2.1	>2.1
Others	ICP:6-12 (cm H2O)	CSF gram stain, CSF culture, CSF bacterial antigen	PCR of HSV-DNA, VZV	CSF gram stain, CSF india ink	PCR of TBC-DNA	CSF tumor markers such as alpha fetoproteins, CEA

Gallery

Cryptococcosis of lung in patient with AIDS. From Public Health Image Library (PHIL). ^[7]
Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). ^[7]
Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). ^[7]
Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). ^[7]
Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). ^[7]
Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). ^[7]
Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using GMS stain. From Public Health Image Library (PHIL). ^[7]
Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using Mucicarmine stain. From Public Health Image Library (PHIL). ^[7]
Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). ^[7]
Cryptococcus neoformans fungi from a liver specimen, and stained using the periodic acid-Schiff staining technique (980X mag). From Public Health Image Library (PHIL). ^[7]
Methenamine silver-stained photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800X mag). From Public Health Image Library (PHIL). ^[7]
Photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800x mag). From Public Health Image Library (PHIL). ^[7]
Periodic acid-Schiff-stained photomicrograph revealed some of the histopathologic details associated with a disseminated Cryptococcus sp. infection involving the liver (980x mag). From Public Health Image Library (PHIL). ^[7]

References

↑ ^1.0 ^1.1 Le Rhun E, Taillibert S, Chamberlain MC (2013). "Carcinomatous meningitis: Leptomeningeal metastases in solid tumors". Surg Neurol Int. 4 (Suppl 4): S265–88. doi:10.4103/2152-7806.111304. PMC 3656567. PMID 23717798.
↑ ^2.0 ^2.1 Chow E, Troy SB (2014). "The differential diagnosis of hypoglycorrhachia in adult patients". Am J Med Sci. 348 (3): 186–90. doi:10.1097/MAJ.0000000000000217. PMC 4065645. PMID 24326618.
↑ ^3.0 ^3.1 Leen WG, Willemsen MA, Wevers RA, Verbeek MM (2012). "Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice". PLoS One. 7 (8): e42745. doi:10.1371/journal.pone.0042745. PMC 3412827. PMID 22880096.
↑ ^4.0 ^4.1 ^4.2 Negrini B, Kelleher KJ, Wald ER (2000). "Cerebrospinal fluid findings in aseptic versus bacterial meningitis". Pediatrics. 105 (2): 316–9. PMID 10654948.
↑ Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.
↑ Caudie C, Tholance Y, Quadrio I, Peysson S (2010). "[Contribution of CSF analysis to diagnosis and follow-up of tuberculous meningitis]". Ann Biol Clin (Paris). 68 (1): 107–11. doi:10.1684/abc.2010.0407. PMID 20146981.
↑ ^7.00 ^7.01 ^7.02 ^7.03 ^7.04 ^7.05 ^7.06 ^7.07 ^7.08 ^7.09 ^7.10 ^7.11 ^7.12 "Public Health Image Library (PHIL)".

[pmid23717798-1] 1.0 ^1.1 Le Rhun E, Taillibert S, Chamberlain MC (2013). "Carcinomatous meningitis: Leptomeningeal metastases in solid tumors". Surg Neurol Int. 4 (Suppl 4): S265–88. doi:10.4103/2152-7806.111304. PMC 3656567. PMID 23717798.

[pmid24326618-2] 2.0 ^2.1 Chow E, Troy SB (2014). "The differential diagnosis of hypoglycorrhachia in adult patients". Am J Med Sci. 348 (3): 186–90. doi:10.1097/MAJ.0000000000000217. PMC 4065645. PMID 24326618.

[pmid22880096-3] 3.0 ^3.1 Leen WG, Willemsen MA, Wevers RA, Verbeek MM (2012). "Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice". PLoS One. 7 (8): e42745. doi:10.1371/journal.pone.0042745. PMC 3412827. PMID 22880096.

[pmid10654948-4] 4.0 ^4.1 ^4.2 Negrini B, Kelleher KJ, Wald ER (2000). "Cerebrospinal fluid findings in aseptic versus bacterial meningitis". Pediatrics. 105 (2): 316–9. PMID 10654948.

[pmid20610819-5] Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.

[pmid20146981-6] Caudie C, Tholance Y, Quadrio I, Peysson S (2010). "[Contribution of CSF analysis to diagnosis and follow-up of tuberculous meningitis]". Ann Biol Clin (Paris). 68 (1): 107–11. doi:10.1684/abc.2010.0407. PMID 20146981.

[PHIL-7] 7.00 ^7.01 ^7.02 ^7.03 ^7.04 ^7.05 ^7.06 ^7.07 ^7.08 ^7.09 ^7.10 ^7.11 ^7.12 "Public Health Image Library (PHIL)".

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[2]

[3]

[4]

[5]

[6]

[7]

@@ Line 3: / Line 3: @@
 ==Other Diagnostic studies==
-**India ink or fungal wet mount of [[CSF]] will demonstrate a ([[Yeast|budding yeast]]).
+*India ink or fungal wet mount of [[CSF]] will demonstrate a ([[Yeast|budding yeast]]).
-**[[Mucicarmine]] stain provides specific staining of the [[polysaccharide]] cell wall.
+*[[Mucicarmine]] stain provides specific staining of the [[polysaccharide]] cell wall.
-**[[Antigen]] detection in [[CSF]] is useful for the diagnosis of cryptococcal meningitis.
+*[[Antigen]] detection in [[CSF]] is useful for the diagnosis of cryptococcal meningitis.
+Fungal meningitis may be differentiated from other causes of [[meningitis]] by [[cerebrospinal fluid]] examination as shown below:<ref name="pmid23717798">{{cite journal| author=Le Rhun E, Taillibert S, Chamberlain MC| title=Carcinomatous meningitis: Leptomeningeal metastases in solid tumors. | journal=Surg Neurol Int | year= 2013 | volume= 4 | issue= Suppl 4 | pages= S265-88 | pmid=23717798 | doi=10.4103/2152-7806.111304 | pmc=3656567 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23717798  }} </ref><ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618  }} </ref><ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096  }} </ref><ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948  }} </ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref>
+{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
+|+
+! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Cerebrospinal fluid level}}
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Normal level}}
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Bacterial meningitis}}<ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948  }} </ref>
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Viral meningitis}}<ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948  }} </ref>
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Fungal meningitis}}
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Tuberculous meningitis}}<ref name="pmid20146981">{{cite journal| author=Caudie C, Tholance Y, Quadrio I, Peysson S| title=[Contribution of CSF analysis to diagnosis and follow-up of tuberculous meningitis]. | journal=Ann Biol Clin (Paris) | year= 2010 | volume= 68 | issue= 1 | pages= 107-11 | pmid=20146981 | doi=10.1684/abc.2010.0407 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20146981  }} </ref>
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Malignant meningitis}}<ref name="pmid23717798">{{cite journal| author=Le Rhun E, Taillibert S, Chamberlain MC| title=Carcinomatous meningitis: Leptomeningeal metastases in solid tumors. | journal=Surg Neurol Int | year= 2013 | volume= 4 | issue= Suppl 4 | pages= S265-88 | pmid=23717798 | doi=10.4103/2152-7806.111304 | pmc=3656567 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23717798  }} </ref>
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" | '''Cells/ul'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''< 5'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''>300'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''10-1000'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''10-500'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''50-500'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''>4'''
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |'''Cells'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte]]:[[Monocyte]] 7:3'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Granulocyte]] > [[Lymphocyte]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte]] > [[Granulocyte]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte|Lympho]].>[[Granulocyte]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte|Lymphocytes]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte|Lymphocytes]]'''
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |'''Total [[protein]] (mg/dl''')
+| style="padding: 5px 5px; background: #F5F5F5;" |'''45-60'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''Typically 100-500'''
+| style="padding: 5px 5px; background: #F5F5F5;" | '''Normal or slightly high'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''High'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''Typically 100-200'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''>50'''
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Glucose]] ratio ([[CSF]]/[[Plasma|plasma)]]<ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618  }} </ref>'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''> 0.5'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''< 0.3'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''> 0.6'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''<0.3'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''< 0.5'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''<0.5'''
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Lactate]] (mmols/l)<ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096  }} </ref>'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''< 2.1'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''> 2.1'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''< 2.1'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''>3.2'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''> 2.1'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''>2.1'''
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |'''Others'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''ICP:6-12 (cm H2O)'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Gram stain|CSF gram stain]], [[Culture medium|CSF culture]], [[CSF]] [[Antigen|bacterial antigen]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[PCR]] of [[HSV|HSV-DNA]], [[VZV]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Gram stain|CSF gram stain]], CSF india ink'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[PCR]] of TBC-[[DNA]]'''
+| style="padding: 5px 5px; background: #F5F5F5;" |'''[[CSF]] [[tumor markers]] such as [[Alpha fetoprotein|alpha fetoproteins]], [[CEA]]'''
+|-
+|}
 ==Gallery==

Cryptococcosis other diagnostic studies: Difference between revisions

Revision as of 15:43, 5 June 2017

Other Diagnostic studies

Gallery

References

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