Sensitivity of Cerebrospinal Fluid Cytology for the Diagnosis of Cryptococcal Infections

McHugh, Kelsey; Gersey, Melanie; Rhoads, Daniel D.; Procop, Gary W.; Zhang, Yaxia; Booth, Christine N.; Sturgis, Charles D.

doi:10.1093/ajcp/aqy133

Cited by 6 publications

(8 citation statements)

References 39 publications

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“…Fungal infections usually occur in immunocompromised individuals. However, in our study, a large proportion 15/27 (55.6%) of patients with CNS fungal infections had normal immune function[ 21 ]. There are increasing reports of immunocompetent patients with fungal infections, possibly due to the exposures to environmental genetic factors.…”

Section: Discussionmentioning

confidence: 91%

Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases of the central nervous system after empirical treatment

Chen¹,

Guo²,

Xue³

et al. 2022

WJCC

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BACKGROUND The diagnostic value of metagenomic next-generation sequencing (mNGS) in central nervous system (CNS) infectious diseases after empirical treatment has not been reported. AIM To investigate the diagnostic value of mNGS of cerebrospinal fluid (CSF) in the empirically treated CNS infectious diseases. METHODS A total of 262 CSF samples from patients with suspected CNS infections were collected between August 2020 and December 2021. Both mNGS and conventional methods were used for testing. The conventional methods included microbial culture, smear, polymerase chain reaction, etc. RESULTS Among 262 suspected cases, 183 cases (69.84%) were diagnosed as CNS infection, including 86 cases of virus infection (47.00%), 70 cases of bacterial infection (38.25%) and 27 cases of fungal infection (14.76%). The sensitivity and specificity of mNGS were 65.6% (95%CI: 58.2%-72.3%) and 89.6% (95%CI: 79.1%-95.3%), respectively. The PPV of mNGS was 94.5% (95%CI: 88.6%-97.6%), and the NPV was 48.8% (95%CI: 39.7%–57.9%). The pathogen detective sensitivity and accuracy of mNGS were higher than those of conventional methods (Sensitivity: 65.6% vs 37.2%; P < 0.001; Accuracy: 72.0% vs 50%, P < 0.001). The results showed that compared with conventional methods, mNGS technology was a more sensitive method for the diagnosis of CNS infection after empirical treatment. CONCLUSION mNGS can be a better method applied in the diagnosis of CNS infection after empirical treatment.

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Section: Discussionmentioning

confidence: 91%

Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases of the central nervous system after empirical treatment

Chen¹,

Guo²,

Xue³

et al. 2022

WJCC

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“…Unlike PCR, mNGS does not require primers or specific amplification and is less affected by the use of antibiotics and the body's immune status ( 30 ). It can directly sequence the base sequences in the samples ( 31 ) and obtain the genome sequences of a variety of pathogens that may be infected in the samples by one-time detection, which is characterized by rapid and high accuracy ( 32 ). Therefore, it can be used to cultivate pathogens that are difficult to find or have a relatively low culture rate or a long period of time ( 33 ), predict infection in advance by detecting microecology ( 34 ), predict drug sensitivity ( 31 ), interpret the diversity and abundance of pathogen population, and explore the relationship between pathogen, environment and host.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Diagnostic Value of Metagenomics Next Generation Sequencing in Intracranial Infection Caused by Mucor

et al. 2021

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mNGS(metagenomics Next Generation Sequencing), as a novel culture-independent approach, demonstrated the capability of rapid, sensitive, and accurate pathogen identification. At present, there have been many case reports about the use of mNGS to assist in the diagnosis of bacterial, fungal, viral and parasitic infections and to guide clinicians to determine appropriate treatment. However, the clinical understanding of this technique is not comprehensive, and the experience of using it is relatively limited. We reported a 53-year-old man who was admitted to hospital with a high fever and headache. His inflammatory biomarkers were markedly elevated. Based on the clinical presentation, He was initially diagnosed as having an intracranial infection of unknown etiology and received empirical antibiotics and systemic supportive treatment. But these did not relieve his symptoms. Both the blood and CSF specimens were examined using traditional culture, serological testing, and mNGS. Traditional culture and serological testing produced negative results, while the mNGS revealed the presence of a potential pathogen, mucor, in the CSF specimen. Then targeted antifungal treatment was selected quickly and his temperature gradually returned to normal. Thus, we report the case in which mNGS was an auxiliary method to diagnose mucormycosis, and discuss this case in combination with relevant literature, in order to improve the clinical cognition of this technology.

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“…Cerebrospinal fluid (CSF) analysis for cytopathological diagnosis plays a pivotal role in the diagnosis and management of a wide array of neurological disorders, including infections, [1][2][3][4][5][6] neoplasms, and inflammatory conditions. The cytopathologic examination of CSF specimens offers a minimally invasive means of obtaining valuable diagnostic information, aiding in the identification of abnormal cells, infectious agents, and other pathological processes within the central 1,3,4,[7][8][9][10][11][12][13][14][15] nervous system (CNS).…”

Section: Introductionmentioning

confidence: 99%

“…CSF cytopathological evaluation is compulsory in suspected inflammatory, neoplastic, or hemorrhagic conditions and needs to be interpreted in the clinical [3][4][5][7][8][9][10][11][12][13][14][15][16] context.…”

Section: Introductionmentioning

confidence: 99%

“…CSF cytopathological analysis is a valuable tool in understanding the pathogenesis of neuroinflammatory diseases, 16 particularly multiple sclerosis. The most common infectious, primary neoplastic, and secondary neoplastic lesions detected through CSF cytopathologic analysis include Cryptococcus neoformans infection, medulloblastoma, and non-Hodgkin lymphoma (NHL)/metastatic breast 3,[11][12][13][14][15]17 carcinoma respectively.…”

Section: Introductionmentioning

confidence: 99%

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15-Year Retrospective Survey of the Cytopathologic Spectrum of Cerebrospinal Fluid Aspirate in a Teaching Hospital in Uyo, Southern Nigeria

Eziagu UB,

Wemimo RM,

Nwafor CC

et al. 2024

Ibom Med J

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Background: The cytopathologic evaluation of cerebrospinal fluid (CSF) aspirates is a vital diagnostic tool for neurological disorders. This research aimed to characterize the diverse range of cytopathological diagnoses encountered in the CSF specimens within 15 years in a teaching hospital while highlighting their clinical significance. Materials and Methods: A thorough review of cytopathology records from January 1, 2006, to December 31, 2020, was conducted. CSF samples were collected through lumbar punctures and subsequently subjected to cytopathological examination. The data were collected from the Department of Histopathology, University of Uyo Teaching Hospital archives. The inclusion criteria encompassed all cases with available CSF cytopathology results during the study period. Cases with inadequate or missing data were excluded from the analysis. Data regarding patients’ ages, sex, clinical, and cytopathologic diagnoses were extracted and analyzed. Results: Thirty-four (34) CSF samples were analyzed during the study period. The mean age was 11.45 ± 12.20 years. The most common clinical indication for CSF analysis was suspected Burkitt’s Lymphoma (34.78%), followed by other Non-Hodgkin Lymphoma (13.04%). The cytopathologic diagnoses exhibited a diverse spectrum, including Acellular Smear (26.5%), Inflammatory Smear (2.9%), Negative for Malignant Cells (52.9%), Positive for Malignant Cells (14.7%), and Suspicious for Malignant Cells (2.9%). This study also observed a significant association between age groups (particularly 0-10 years) and cytopathological diagnoses, with a p-value of 0.023. Conclusion: A retrospective survey of CSF cytopathology in a Nigerian teaching hospital reveals diverse cytopathological diagnoses, providing insights for neuropathology clinicians and researchers.

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Sensitivity of Cerebrospinal Fluid Cytology for the Diagnosis of Cryptococcal Infections

Cited by 6 publications

References 39 publications

Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases of the central nervous system after empirical treatment

Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases of the central nervous system after empirical treatment

Case Report: Diagnostic Value of Metagenomics Next Generation Sequencing in Intracranial Infection Caused by Mucor

15-Year Retrospective Survey of the Cytopathologic Spectrum of Cerebrospinal Fluid Aspirate in a Teaching Hospital in Uyo, Southern Nigeria

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