False-negative Histoplasma antigen in acute pulmonary histoplasmosis: the value of urinary concentration by ultrafiltration and heat denaturation of serum proteins in detection of Histoplasma antigen

Pediatr Infect Dis J. 2009 May;28(5):447-9. doi: 10.1097/INF.0b013e318193ecc1.

Abstract

We report an infant with localized pulmonary histoplasmosis in whom Histoplasma antibody assays, quantitative Histoplasma urine and serum antigen concentrations, and histopathologic findings of a mediastinal mass were nondiagnostic. A provisional diagnosis of histoplasmosis was established by using laboratory methods that increase the sensitivity of the antigen assay using ultrafiltration of urine and ethylenediaminetetraacetic acid/heat denaturation of serum proteins.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Antigens, Fungal / isolation & purification*
  • Antigens, Fungal / urine
  • Histoplasma / isolation & purification*
  • Histoplasmosis / diagnosis
  • Histoplasmosis / drug therapy
  • Histoplasmosis / microbiology*
  • Hot Temperature
  • Humans
  • Infant
  • Itraconazole / therapeutic use
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / microbiology*
  • Male
  • Prednisone / therapeutic use
  • Protein Denaturation*
  • Sensitivity and Specificity
  • Ultrafiltration / methods

Substances

  • Anti-Inflammatory Agents
  • Antifungal Agents
  • Antigens, Fungal
  • Itraconazole
  • Prednisone