Rapid PCR-Based Diagnosis of Disseminated Histoplasmosis in an AIDS Patient

Rickerts, Volker; Bialek, Ralf; Tintelnot, Kathrin; Jacobi, Volkmar; Just‐Nübling, G.

doi:10.1007/s10096-002-0833-y

Cited by 44 publications

(22 citation statements)

References 8 publications

(16 reference statements)

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“…Most patients with cancer and acute histoplasmosis in this study were male, although this proportion was not statistically different from the proportion in the population of patients with cancer cared for during the study period (P = .190; expected number of boys among 33 patients, [13][14][15][16][17][18][19][20][21][22][23][24][25]. A similar preponderance of male patients has been found by serosurveys of healthy children and those undergoing evaluation for mediastinal masses.…”

Section: Discussionsupporting

confidence: 73%

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Histoplasmosis in a pediatric oncology center

Adderson

2004

The Journal of Pediatrics

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Section: Discussionsupporting

confidence: 73%

“…Recently PCR has been used to identify H capsulatum in tissue and bronchoalveolar lavage fluid. 21, 22 The further development and routine use of rapid diagnostic tests would facilitate optimal management of histoplasmosis.…”

Section: Discussionmentioning

confidence: 99%

Histoplasmosis in a pediatric oncology center

Adderson

2004

The Journal of Pediatrics

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“…Several laboratories are working on developing PCR assays that might help with a more rapid identification of a mold as H. capsulatum in vitro in the laboratory and in infected tissues obtained by biopsy (24,81,105). At this point, no PCR assay for routine use is commercially available.…”

Section: Pcr Assaysmentioning

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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“…Palavras-chave: testes diagnósticos, métodos baseados em cultura, métodos moleculares e sorologia Adapted from (10,11,14,18,68,114).…”

Section: Resumo Diagnóstico Laboratorial Da Histoplasmoseunclassified

“…The result of these studies is that PCR can be a useful additional tool for diagnosis of H. capsulatum, especially in non-endemic regions, to complement antigen detection and serological methods. Additionally, the molecular methods are safer, limiting the possibility of laboratory infection, due to degradation of the pathogen by the genetic material extraction (114).…”

Section: Molecular Based Methodsmentioning

confidence: 99%

Diagnosis of histoplasmosis

Guimarães

Nosanchuk²,

Zancopé‐Oliveira³

2006

Braz. J. Microbiol.

172

206

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Endemic mycoses can be challenging to diagnose and accurate interpretation of laboratory data is important to ensure the most appropriate treatment for the patients. Although the definitive diagnosis of histoplasmosis (HP), one of the most frequent endemic mycoses in the world, is achieved by direct diagnosis performed by micro and/or macroscopic observation of Histoplasma capsulatum (H. capsulatum), serologic evidence of this fungal infection is important since the isolation of the etiologic agents is time-consuming and insensitive. A variety of immunoassays have been used to detect specific antibodies to H. capsulatum. The most applied technique for antibody detection is immunodiffusion with sensitivity between 70 to 100 % and specificity of 100%, depending on the clinical form. The complement fixation (CF) test, a methodology extensively used on the past, is less specific (60 to 90%). Detecting fungal antigens by immunoassays is valuable in immunocompromised individuals where such assays achieve positive predictive values of 96-98%. Most current tests in diagnostic laboratories still utilize unpurified antigenic complexes from either whole fungal cells or their culture filtrates. Emphasis has shifted, however, to clinical immunoassays using highly purified and well-characterized antigens including recombinant antigens. In this paper, we review the current conventional diagnostic tools, such as complement fixation and immunodiffusion, outline the development of novel diagnostic reagents and methods, and discuss their relative merits and disadvantages to the immunodiagnostic of this mycosis.

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Rapid PCR-Based Diagnosis of Disseminated Histoplasmosis in an AIDS Patient

Cited by 44 publications

References 8 publications

Histoplasmosis in a pediatric oncology center

Histoplasmosis in a pediatric oncology center

Histoplasmosis: a Clinical and Laboratory Update

Diagnosis of histoplasmosis

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