The performance of serum cryptococcal capsular polysaccharide antigen test, histopathology and culture of the lung tissue for diagnosis of pulmonary cryptococcosis in patients without HIV infection

被引:29
作者
Zhou, Ying [1 ]
Li, Peng-Cheng [1 ]
Ye, Jun-Ru [1 ]
Su, Shan-Shan [1 ]
Dong, Li [1 ]
Wu, Qing [2 ]
Xu, Han-Yan [1 ]
Xie, Yu-Peng [1 ]
Li, Yu-Ping [1 ]
机构
[1] Wenzhou Med Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, Wenzhou 325015, Zhejiang, Peoples R China
[2] Wenzhou Med Univ, Affiliated Hosp 1, Ctr Lab & Diag, Wenzhou 325015, Zhejiang, Peoples R China
关键词
pulmonary cryptococcosis; fungal infection; Cryptococcus neoformans; cryptococcal capsular polysaccharide antigen; diagnosis; CLINICAL ANALYSIS; DISEASE; BIOPSY;
D O I
10.2147/IDR.S178391
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Clinicians may fail to make an early diagnosis of pulmonary cryptococcosis (PC) without HIV infection. Serum cryptococcal capsular polysaccharide antigen (CrAg) test, histopathology and culture of lung tissue play different roles in diagnosis of PC. Objective: To investigate the performance of serum CrAg test, histopathology and culture of the lung tissue in diagnosis of PC without HIV infection. Patients/methods: From January 2011 to September 2017, patients with proven PC were recruited from a teaching hospital in southern China. Those patients with HIV infection, PC confirmed by surgery or PC with probable or possible diagnosis were excluded from the study. Latex agglutination test and CrAg lateral flow assay were used for detection of scrum CrAg. Lung biopsy and needle aspiration were performed under computed tomography guidance. Results: Eighty-nine patients with proven PC including 41 male (46.1%) and 48 female (53.9%) were enrolled. Fifty-one (57.3%) patients had underlying disease. Positive CrAg test was found in 83 (93.3%) cases. Among six cases with negative CrAg test, PC was confirmed by histology in two cases and positive culture in four cases. The histopathological results of 77 (86.5%) cases revealed cryptococcal granuloma and 12 cases showed chronic inflammation, which was confirmed by positive culture. Among 65 cases, the diseased tissue of 46 (70.8%) cases presented Cryptococcus neoformans in the culture and one case was diagnosed with lung cancer coexisting with PC. Conclusion: Our findings showed that serum CrAg test is rapid and sensitive in diagnosing PC, histology is important for confirming PC and culture plays a complementary role. Biopsied lung tissue should be submitted for cultures whenever feasible.
引用
收藏
页码:2483 / 2490
页数:8
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