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