Aspergillus meningitis: diagnosis by non-culture-based microbiological methods and management

J Clin Microbiol. 1999 Apr;37(4):1186-9. doi: 10.1128/JCM.37.4.1186-1189.1999.

Abstract

The performance of antibody detection, antigen detection, and Aspergillus genus-specific PCR for diagnosing Aspergillus meningitis was investigated with 26 cerebrospinal fluid (CSF) samples obtained from a single patient with proven infection caused by Aspergillus fumigatus. Immunoglobulin G antibodies directed against Aspergillus were not detected by enzyme-linked immunosorbent assay in CSF or serum. The antigen galactomannan was detected in the CSF 45 days before a culture became positive, and Aspergillus DNA was detected 4 days prior to culture. Decline of the galactomannan antigen titer in the CSF during treatment with intravenous and intraventricular amphotericin B and intravenous voriconazole corresponded with the clinical response to treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use
  • Antibodies, Fungal / blood
  • Antibodies, Fungal / cerebrospinal fluid
  • Antifungal Agents / therapeutic use
  • Antigens, Fungal / cerebrospinal fluid
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy
  • Aspergillus fumigatus / drug effects
  • Aspergillus fumigatus / genetics
  • Aspergillus fumigatus / immunology
  • DNA, Fungal / cerebrospinal fluid
  • DNA, Fungal / genetics
  • Drug Resistance, Microbial
  • Female
  • Galactose / analogs & derivatives
  • Humans
  • Mannans / cerebrospinal fluid
  • Mannans / immunology
  • Meningitis, Fungal / diagnosis*
  • Meningitis, Fungal / drug therapy
  • Mycology / methods*
  • Polymerase Chain Reaction
  • Pyrimidines / therapeutic use
  • Time Factors
  • Triazoles / therapeutic use
  • Voriconazole

Substances

  • Antibodies, Fungal
  • Antifungal Agents
  • Antigens, Fungal
  • DNA, Fungal
  • Mannans
  • Pyrimidines
  • Triazoles
  • galactomannan
  • Amphotericin B
  • Voriconazole
  • Galactose