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Use of Image Cytometry for Quantification of Pathogenic Fungi in Association with Host Cells
Published on: June 19, 2013
Routine CSF analysis in coccidioidomycosis is not required.
George Thompson1, Sharon Wang, Robert Bercovitch
1Coccidioidomycosis Serology Laboratory, Department of Medical Microbiology and Immunology, University of California Davis, Davis, California, United States of America. grthompson@ucdavis.edu
Plos One
|May 30, 2013
Summary
Routine cerebrospinal fluid (CSF) examination may not be necessary for all patients with coccidioidomycosis. The study found that coccidioidal meningitis only occurred in patients exhibiting central nervous system (CNS) symptoms.
Area of Science:
- Infectious Diseases
- Neurology
- Clinical Medicine
Background:
- Coccidioidomycosis is a fungal infection endemic to certain regions.
- Disseminated infection and coccidioidal meningitis are serious complications.
- Routine cerebrospinal fluid (CSF) examination is often performed in at-risk patients.
Purpose of the Study:
- To evaluate the utility of routine CSF examination in patients with active coccidioidomycosis.
- To determine if asymptomatic patients with risk factors require CSF analysis.
- To assess the diagnostic yield of lumbar puncture in the absence of CNS symptoms.
Main Methods:
- Retrospective review of patients with active coccidioidomycosis.
- Analysis of clinical signs and symptoms of central nervous system (CNS) involvement.
- Correlation of CSF findings with antibody titers and risk factors for dissemination.
Main Results:
- All patients diagnosed with coccidioidal meningitis presented with at least one CNS sign or symptom.
- Headache was a universal symptom in patients with meningitis.
- No patients without suggestive CNS symptoms were diagnosed with coccidioidal meningitis, regardless of antibody titers or risk factors.
Conclusions:
- Routine lumbar puncture may be unnecessary for coccidioidomycosis patients lacking clinical signs or symptoms of CNS infection.
- Clinical evaluation is paramount in determining the need for CSF analysis.
- This finding could help refine diagnostic protocols and reduce unnecessary invasive procedures.
