Diagnosis of Histoplasmosis in Patients with the Acquired Immunodeficiency Syndrome by Detection of<i>Histoplasma capsulatum</i>Polysaccharide Antigen in Bronchoalveolar Lavage Fluid

Lj, Wheat; Connolly‐Stringfield, Patricia; Williams, Brian J.; Connolly, Kathleen; Blair, Robinette; Bartlett, Marilyn S.; Durkin, Michelle

doi:10.1164/ajrccm/145.6.1421

Cited by 86 publications

(44 citation statements)

References 3 publications

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“…In patients with pulmonary histoplasmosis, BAL fluid Histoplasma antigen may serve as a useful adjunct to urine and serum testing. An earlier study among HIV/AIDS patients showed a BAL fluid Histoplasma antigen sensitivity of 70% compared to 93% in urine and 88.5% in serum (17). However, in a more recent study, the sensitivity of BAL fluid antigen testing was superior (93%) to those of both urine (79%) and serum (65%) and identified cases that were missed by the urine and serum methods (9).…”

Section: Antigen Detectionmentioning

confidence: 93%

Laboratory Diagnostics for Histoplasmosis

2017

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The diagnosis of histoplasmosis is based on a multifaceted approach that includes clinical, radiographic, and laboratory evidence of disease. The gold standards for laboratory diagnosis include demonstration of yeast on pathological examination of tissue and isolation of the mold in the culture of clinical specimens; however, antigen detection has provided a rapid, noninvasive, and highly sensitive method for diagnosis and is a useful marker of treatment response. Molecular methods with improved sensitivity on clinical specimens are being developed but are not yet ready for widespread clinical use. This review synthesizes currently available laboratory diagnostics for histoplasmosis, with an emphasis on complexities of testing and performance in various clinical contexts.

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Section: Antigen Detectionmentioning

confidence: 93%

Laboratory Diagnostics for Histoplasmosis

2017

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“…There are few data on the usefulness of the Histoplasma antigen assay for bronchoalveolar lavage fluid obtained from patients with diffuse pulmonary infiltrates due to histoplasmosis (149). The 27 patients studied were all AIDS patients, and antigen was detected in 19 (70%) of those patients, a sensitivity less than that of urine, which was 93%.…”

Section: Antigen Detectionmentioning

confidence: 99%

Histoplasmosis: a Clinical and Laboratory Update

2007

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SUMMARY Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

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“…Cross-reactivity can occur with blastomycosis, paracoccidioidomycosis, and penicilliosis, and falsepositive results in serum have been observed in 16% of SOT patients who received rabbit antithymocyte globulin (391). Detection of antigen in body fluids (e.g., bronchoalveolar lavage fluid and CSF) offers a valuable approach for rapid diagnosis in patients with progressive disseminated histoplasmosis and diffuse pulmonary histoplasmosis (392,395).…”

Section: Infections Caused By Histoplasma Capsulatummentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Diagnosis of Histoplasmosis in Patients with the Acquired Immunodeficiency Syndrome by Detection ofHistoplasma capsulatumPolysaccharide Antigen in Bronchoalveolar Lavage Fluid

Cited by 86 publications

References 3 publications

Laboratory Diagnostics for Histoplasmosis

Laboratory Diagnostics for Histoplasmosis

Histoplasmosis: a Clinical and Laboratory Update

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

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