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Interlaboratory discrepancy of antigenuria results in 2 patients with AIDS and histoplasmosis
David S McKinsey1, Joel P McKinsey, Noelle Northcutt
1Infectious Disease Associates of Kansas City, Kansas City, MO 64132, USA. david.mckinsey@hcamidwest.com
Abstract:
Histoplasma polysaccharide antigen testing is used routinely to diagnose histoplasmosis. At least 3 antigen tests are commercially available. Controversy exists about the relative accuracy of these tests. We report 2 patients with AIDS and culture-confirmed Histoplasma capsulatum meningitis from whom discrepant Histoplasma polysaccharide antigen results were obtained from different laboratories and discuss the potential clinical implications of these results.
Insights
Histoplasma antigen tests can yield different results between labs, even in severe meningitis cases. This highlights the need for careful interpretation of diagnostic testing for Histoplasma infections.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Histoplasma polysaccharide antigen testing is a common diagnostic tool for histoplasmosis.
- Several commercial antigen tests are available, but their comparative accuracy is debated.
- Accurate diagnosis is crucial for timely and effective treatment of histoplasmosis.
Observation:
- Two patients with Acquired Immunodeficiency Syndrome (AIDS) and culture-confirmed Histoplasma capsulatum meningitis were studied.
- Discrepant Histoplasma polysaccharide antigen test results were observed between different laboratories for these patients.
- The patients presented with severe neurological complications of histoplasmosis.
Findings:
- The study identified variability in Histoplasma antigen test performance across different laboratory settings.
- Discrepancies in antigen test results can occur even in cases of disseminated and severe fungal infections.
- Culture confirmation remains a critical component in diagnosing complex Histoplasma infections.
Implications:
- Clinical decisions regarding histoplasmosis treatment may be affected by variable antigen test accuracy.
- Healthcare providers should be aware of potential discrepancies in Histoplasma antigen testing.
- Further research is needed to standardize and improve the reliability of Histoplasma antigen detection methods.
