Diagnostic value of determination of serum mannan concentrations in patients with candiduria

Abstract

The diagnostic value of determination of serum mannan levels was studied in 41 patients with candiduria and 20 control patients without candiduria. The patients with candiduria comprised 18 asymptomatic afebrile patients (group 1) and 23 febrile patients with suspected Candida pyelonephritis (group 2). Mannan antigenemia (> or equal to 0.5 ng/ml) was detected in 14 patients in group 2, this rate being significantly higher than the rate of four patients in group 1 (p < 0.05) and none in the control group (p < 0.01). Serum mannan levels decreased gradually and became undetectable in six patients in whom therapy with an anticandidal agent was effective. Determination of serum mannan levels may be a useful parameter in diagnosing Candida pyelonephritis and deciding on effective treatment.

An Italian consensus for invasive candidiasis management (ITALIC)

“…For the diagnosis of IC, two methods have been proposed. The search for mannan antigen and antimannan antibodies separately have low sensitivity and specificity, which improve substantially when the two methods are combined [40][41][42][43]. The sensitivity and specificity of these tests have been questioned when used separately, but a number of reports indicate that, when they are used in combination, the performance improves substantially [41,44].…”