Histopathology, serology and cultures in the diagnosis of cryptococcosis

Gazzoni, Alexandra Flávia; Severo, Cecília Bittencourt; Salles, Emily Ferreira; Severo, Luiz Carlos

doi:10.1590/s0036-46652009000500004

Cited by 47 publications

(61 citation statements)

References 24 publications

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“…Cryptococci are encapsulated, spherical to oval yeast that measure 5 to 10 m in diameter and have narrow-based budding ( Fig. 1) (31,56). A thick polysaccharide capsule gives these organisms the characteristic appearance of having a clear space around them that can be seen in tissue sections with H&E stains.…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

“…Because of the capsule, the buds appear separate from the mother cells. The polysac- (31,56). The granulomatous inflammatory reactions also show a spectrum from abundant necrosis to fibrous granulomas.…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

“…Staining these specimens with FontanaMasson stain may prove that the yeast produces melanin, which is characteristic of cryptococci. The use of cryptococcal antigen tests with serum and CSF may not be helpful for patients with poorly encapsulated cryptococci, because most of the serologic tests detect antigens present in the capsule (56).…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

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Histopathologic Diagnosis of Fungal Infections in the 21st Century

2011

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SUMMARY Fungal infections are becoming more frequent because of expansion of at-risk populations and the use of treatment modalities that permit longer survival of these patients. Because histopathologic examination of tissues detects fungal invasion of tissues and vessels as well as the host reaction to the fungus, it is and will remain an important tool to define the diagnostic significance of positive culture isolates or results from PCR testing. However, there are very few instances where the morphological characteristics of fungi are specific. Therefore, histopathologic diagnosis should be primarily descriptive of the fungus and should include the presence or absence of tissue invasion and the host reaction to the infection. The pathology report should also include a comment stating the most frequent fungi associated with that morphology as well as other possible fungi and parasites that should be considered in the differential diagnosis. Alternate techniques have been used to determine the specific agent present in the histopathologic specimen, including immunohistochemistry, in situ hybridization, and PCR. In addition, techniques such as laser microdissection will be useful to detect the now more frequently recognized dual fungal infections and the local environment in which this phenomenon occurs.

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Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

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Histopathologic Diagnosis of Fungal Infections in the 21st Century

2011

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“…Most tissue stains are inexpensive and can be performed easily in various specimens, such as sputum, BAL fluid, aspirates from lesions, cerebrospinal fluid (CSF), and other tissues (46,47). Fungi are identified based on size and morphological characteristics, which are generally nonspecific, thus allowing only for a descriptive diagnosis (48)(49)(50). Stains do not always allow for accurate identification; for example, Aspergillus spp., Fusarium spp., and Scedosporium spp.…”

Section: Invasive Aspergillosismentioning

confidence: 99%

Molecular and Nonmolecular Diagnostic Methods for Invasive Fungal Infections

et al. 2014

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SUMMARY Invasive fungal infections constitute a serious threat to an ever-growing population of immunocompromised individuals and other individuals at risk. Traditional diagnostic methods, such as histopathology and culture, which are still considered the gold standards, have low sensitivity, which underscores the need for the development of new means of detecting fungal infectious agents. Indeed, novel serologic and molecular techniques have been developed and are currently under clinical evaluation. Tests like the galactomannan antigen test for aspergillosis and the β-glucan test for invasive Candida spp. and molds, as well as other antigen and antibody tests, for Cryptococcus spp., Pneumocystis spp., and dimorphic fungi, have already been established as important diagnostic approaches and are implemented in routine clinical practice. On the other hand, PCR and other molecular approaches, such as matrix-assisted laser desorption ionization (MALDI) and fluorescence in situ hybridization (FISH), have proved promising in clinical trials but still need to undergo standardization before their clinical use can become widespread. The purpose of this review is to highlight the different diagnostic approaches that are currently utilized or under development for invasive fungal infections and to identify their performance characteristics and the challenges associated with their use.

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“…False negatives can occur due to low fungal burden or a prozone phenomenon (6). Tests directed against capsular antigens may also be negative in capsule deficient strains (9).…”

mentioning

confidence: 99%