Diagnostic Value of Serum Antibody .and Antigen Detection in Heroin Addicts with Systemic Candidiasis

Bisbe, Josep; Miró, Josep M.; Torres, Javiera; Latorre, X; Alia, C.; Amaral, Marcelo; Estivill, D.; Mallolas, Josép; Trilla, A; Soriano, E

doi:10.1093/clinids/11.2.310

Cited by 15 publications

(11 citation statements)

References 14 publications

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“…Detection of antibodies against Candida species by Candida hemagglutination assay (LD Candida Kit IHA, LD Labor Diagnostika, Heiden, Germany) also supported the diagnosis. Rises in CHA titers to 1:2,560 or higher are reported to be highly specific (87%) and sensitive (75%) [19]. In our patient, the antibody titer increased from 1:640 to 1:2,560 within 10 days.…”

Section: Discussionsupporting

confidence: 46%

Successful conservative treatment of severe renal candidosis with fungus balls

Rebhandl

Saadi

Herneth

et al. 1999

Pediatric Nephrology

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Partial fungal obstruction of the renal collecting system is an unusual finding among infants that poses specific management problems. We report a patient with sepsis and fungal infection of the kidneys post surgery who presented with bilateral fungus balls and was successfully managed by conservative measures. Sonography is the imaging technique of choice in the diagnosis and follow-up of such patients. The need for prompt diagnosis in high-risk patients and the role of sonography are discussed.

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Section: Discussionsupporting

confidence: 46%

Successful conservative treatment of severe renal candidosis with fungus balls

Rebhandl

Saadi

Herneth

et al. 1999

Pediatric Nephrology

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“…Amphotericin B plus 5‐FC is recommended for first‐line systemic therapy (grade D recommendation) 51 . L‐AMB, fluconazole and voriconazole are alternative agents (grade D recommendation) 52–57 …”

Section: Yeastsmentioning

confidence: 99%

Recommendations for the treatment of established fungal infections

Thursky

Playford

Seymour

et al. 2008

Internal Medicine Journal

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Evidence-based guidelines for the treatment of established fungal infections in the adult haematology/oncology setting were developed by a national consensus working group representing clinicians, pharmacists and microbiologists. These updated guidelines replace the previous guidelines published in the Internal Medicine Journal by Slavin et al. in 2004. The guidelines are pathogen-specific and cover the treatment of the most common fungal infections including candidiasis, aspergillosis, cryptococcosis, zygomycosis, fusariosis, scedosporiosis, and dermatophytosis. Recommendations are provided for management of refractory disease or salvage therapies, and special sites of infections such as the cerebral nervous system and the eye. Because of the widespread use newer broad-spectrum triazoles in prophylaxis and empiric therapy, these guidelines should be implemented in concert with the updated prophylaxis and empiric therapy guidelines published by this group. This section of the guidelines is dedicated to the management of established invasive antifungal infections (IFI) in the adult haematology/oncology setting. Our recommendations are based on the antifungal agents licensed for use in Australia at the time of writing, and are organized according to pathogen.Where there is a radiological abnormality on computed tomography (CT)/high resolution computed tomography (HRCT) without early microbiological confirmation, clinicians should consider the most common clinical scenario. Microbiological confirmation with histology and/or culture should be pursued in all cases where the patient's clinical status permits additional investigations, such as bronchoscopy and/or biopsy. Newer diagnostic modalities such as polymerase chain reaction (PCR), galactomannan (GM) testing and molecular sequencing, are becoming increasingly available, particularly at specialist centres, and will play an increasing role in identifying probable and proven fungal infections. They are discussed in detail in the previous section of the guidelines by Morrissey et al.When considering the possibility of mould infections, Aspergillus is still the most likely organism within the Australasian setting.

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“…The first of these, the LA-Candida Antigen Detection System (Immuno-Mycologics, Inc., Norman, Oklahoma) utilizedp olyclonal antimannana ntibodies to detect the antigen in serum pretreated with heat and protease. However, several evaluations by different groups indicated that this testwas too insensitive to be helpful in the early diagnosis of candidiasis (138,139).Asecondcommercial LA test (Pastorex Candida, Bio-RadLaboratories), introduced in 1991 (140),has also been found to be highly specificbut poorly sensitive. The monoclonal antibody,EB-CA1, used in this testisdirected against an epitope derived from C. albicans mannan, but it alsor eacts with several other species including Candida glabrata, Candida parapsilosis ,and Candida tropicalis (141).Inaninitial retrospective evaluation, the test was notedtohave asensitivity of 53%and aspecificity of 100% for the diagnosis of invasive candidiasisinimmunocompetent patients (142).Although samplesw ere pretreatedb yb oilingi nt he presence of EDTA to dissociate immune complexes, the tests howed low sensitivity in patientsw ho had high titers of antimannana ntibodies.…”

Section: Antigen Detectionmentioning

confidence: 99%