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False-Negative Serum Cryptococcal Antigen Lateral Flow Immunoassay Result for a Patient with Disseminated
Yuqiao Xu1,2, Wenying Xia1,2, Fang Ni1,2
1Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.
Abstract:
Cryptococcus neoformans (C. neoformans) is an opportunistic fungal pathogen to humans, which can be acquired from environmental sources. Its most important virulence factor is its polysaccharide capsule, which can be used for diagnostic tests that identify the cryptococcal antigen (CrAg). The CrAg lateral flow assay (LFA) is a dipstick immunochromatographic assay with high sensitivity and specificity; however, several false-negative cases have been reported. Here, we present a case of a false-negative serum CrAg LFA, in which the blood culture from a matched sample was positive for C. neoformans, thus demonstrating the postzone phenomenon.
Insights
A false-negative cryptococcal antigen (CrAg) lateral flow assay (LFA) occurred despite a positive blood culture for Cryptococcus neoformans. This case highlights the postzone phenomenon, a potential pitfall in diagnosing fungal infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Diagnostic Immunology
Background:
- Cryptococcus neoformans is an opportunistic fungal pathogen.
- The polysaccharide capsule of C. neoformans is a key virulence factor and a target for diagnostics.
- The cryptococcal antigen (CrAg) lateral flow assay (LFA) is widely used for diagnosis.
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