Cross-Reactivity in the Histoplasma Antigen Enzyme Immunoassay Caused by Sporotrichosis

Assi, Maha; Lakkis, Iass E.; Wheat, L. Joseph

doi:10.1128/cvi.05017-11

Cited by 38 publications

(28 citation statements)

References 11 publications

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“…The sensitivity for detection of antigenemia is similar to that for antigenuria (100% vs. 97%) in disseminated infection . The specificity of antigen detection is 99%, however, cross‐reactive antigen is detected in 90% of patients with blastomycosis, and has also been reported in the setting of other endemic fungal infections such as sporotrichosis . The degree of antigenuria correlates with the severity of disseminated infection: concentrations of ≥19 ng/mL occurs in 73% of severe cases, 39% of moderately severe cases and 17% of mild cases .…”

Section: Histoplasmosismentioning

confidence: 74%

Endemic Fungal Infections in Solid Organ Transplantation

Miller

Assi

2013

American Journal of Transplantation

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Section: Histoplasmosismentioning

confidence: 74%

Endemic Fungal Infections in Solid Organ Transplantation

Miller

Assi

2013

American Journal of Transplantation

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“…Results from one study suggest that this urine antigen test is highly sensitive and specific for histoplasmosis in cats . However, that study did not include cats with fungal infections other than histoplasmosis, and other fungal species could cause false‐positive results in humans . As such, we cannot confirm the fungal species in the majority of the cats from this series.…”

Section: Discussionmentioning

confidence: 86%

Hemophagocytosis and Histoplasma‐like fungal infection in 32 cats

Schaefer

Rizzi

Royal

2019

Veterinary Clinical Pathol

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Histoplasmosis is one of the most common systemic fungal diseases in cats from the United States. It commonly causes respiratory or disseminated disease and is often associated with one or more cytopenias. Here, we describe 32 cats in which a Histoplasma‐like fungal infection was associated with concurrent hemophagia in at least one sample site, commonly spleen, bone marrow, liver, and/or lymph node. The degree of hemophagia was characterized as moderate or marked in the majority of cases, and in all cases, there was a predominance of phagocytized mature erythrocytes. A few cases also had macrophages with phagocytized erythroid precursors, platelets, and/or neutrophils. Complete blood count results were available for 25 cats, and cytopenias were common (20/25), including solitary anemia (10), anemia and thrombocytopenia (5), solitary neutropenia (2), pancytopenia (2), and anemia and neutropenia (1). Bone marrow samples were only available in a small subset of cases, preventing the further assessment of the causes of the cytopenias. Hemophagocytosis has been previously reported in cats with neoplastic diseases and a cat with calicivirus infection, and likely occurs with other conditions as well, such as hemorrhage or hemolysis. Results of this report suggest that systemic fungal disease is an additional differential to consider when there is hemophagia in a feline cytology sample.

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“…The Histoplasma antigen assay is susceptible to cross-reactivity with other organisms and, thus, is not sufficient to diagnose histoplasmosis in the absence of additional supporting diagnostics. This has been described with Blastomyces, Coccidioides, Paracoccidioides, Sporothrix, Aspergillus, and Talaromyces marneffei [27,29,[32][33][34]. Similarly, a false-positive Aspergillus antigen test may be seen in patients with histoplasmosis, especially those with high titers.…”

Section: Diagnosismentioning

confidence: 90%

Histoplasmosis in Liver Transplant Recipients: Case Reports and a Review of the Literature

Spallone¹,

Dhal²,

Woc-Colburn³

et al. 2020

OBM Transplantation

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We report two cases of histoplasmosis in orthotopic liver transplant (OLT) recipients to illustrate the variable presentations, complications encountered during treatment, the spectrum of diagnostic modalities, and case outcomes. Case 1 describes the insidious presentation of presumed gastrointestinal histoplasmosis 12 years after OLT, which was defined by months of intermittent diarrhea and focal colonic disease on colonoscopy. A diagnosis of Histoplasma capsulatum was ultimately made by broad range PCR performed on colonic tissue. Due to the patient's inability to tolerate itraconazole, treatment consisted of two weeks of liposomal amphotericin B with resolution of colonic ulcers on follow-up colonoscopy. Case 2 illustrates a case of severe pulmonary histoplasmosis with dissemination in an OLT recipient one year after transplantation. Treatment was complicated by the development of acute respiratory distress syndrome requiring mechanical ventilation and hemodynamic shock requiring extracorporeal membrane oxygenation therapy. A review of the literature on histoplasmosis in OLT recipients accompanies our cases and emphasizes the epidemiology, clinical manifestations, diagnosis, treatment, and prevention.

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Cross-Reactivity in the Histoplasma Antigen Enzyme Immunoassay Caused by Sporotrichosis

Abstract: Several endemic mycoses cause cross-reactions in theHistoplasmaantigen enzyme immunoassay. Herein, a positiveHistoplasmaantigen result has been recognized in a patient with sporotrichosis.

Cited by 38 publications

References 11 publications

Endemic Fungal Infections in Solid Organ Transplantation

Endemic Fungal Infections in Solid Organ Transplantation

Hemophagocytosis and Histoplasma‐like fungal infection in 32 cats

Histoplasmosis in Liver Transplant Recipients: Case Reports and a Review of the Literature

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