Related Experiment Video
Updated: Jan 7, 2026
A Soluble Tetrazolium-Based Reduction Assay to Evaluate the Effect of Antibodies on Candida tropicalis Biofilms
Published on: September 16, 2022
Use of (1→3)-β-D-glucan Monitoring to Clear Candida metapsilosis Ventriculitis and Shunt Infection
Dawn Nolt1, Louise E Vaz1, Christina L Lancioni1
1From the Division of Pediatric Infectious Diseases, Department of Pediatrics.
Background:
Candida infections of the central nervous system (CNS) with intracranial shunts are difficult to treat. Cultures of cerebrospinal fluid (CSF) may lack sensitivity in detecting deep cerebral candidiasis.
Methods:
The fungal biomarker (1→3)-β-D-glucan (BDG) in CSF and serum was used to assess therapeutic response in a child with device-associated recurrent infection from Candida metapsilosis . High-dose micafungin was used as the backbone of antifungal therapy.
Results:
Antifungal therapy guided by resolution of elevated CSF and serum BDG provided the assurance of eradication of C. metapsilosis from CNS and peripheral tissues that permitted the insertion of a replacement ventriculoatrial shunt. Following placement of the ventriculoatrial shunt, there was no recurrence of CNS candidiasis.
Conclusion:
Serial monitoring of BDG of CSF and serum allowed an individualized approach for intracranial shunt reimplantation. The child remained free of Candida CNS infection for 19 months before his death of unrelated causes.
Insights
Monitoring the fungal biomarker (1→3)-β-D-glucan (BDG) in cerebrospinal fluid (CSF) and serum effectively guided treatment for a child with recurrent Candida central nervous system (CNS) infections, preventing relapse after shunt replacement.
Area of Science:
- Mycology
- Infectious Diseases
- Pediatric Neurology
Background:
- Central nervous system (CNS) candidiasis, particularly in patients with intracranial shunts, presents significant treatment challenges.
- Cerebrospinal fluid (CSF) cultures often exhibit low sensitivity for diagnosing deep cerebral candidiasis.
- Device-associated recurrent infections require sensitive diagnostic and monitoring tools.
Purpose of the Study:
- To evaluate the utility of the fungal biomarker (1→3)-β-D-glucan (BDG) in CSF and serum for guiding antifungal therapy in a pediatric patient with recurrent CNS candidiasis.
- To assess the role of BDG monitoring in determining the successful eradication of Candida metapsilosis and enabling shunt reimplantation.
Main Methods:
- Serial measurement of (1→3)-β-D-glucan (BDG) in both CSF and serum samples.
- Administration of high-dose micafungin as the primary antifungal agent.
- Therapeutic response assessment based on the resolution of elevated BDG levels.
Main Results:
- Resolution of elevated CSF and serum BDG levels indicated successful eradication of Candida metapsilosis from CNS and peripheral tissues.
- This therapeutic assurance permitted the successful insertion of a replacement ventriculoatrial shunt.
- No recurrence of CNS candidiasis was observed following shunt reimplantation.
Conclusions:
- Serial BDG monitoring in CSF and serum facilitates an individualized treatment approach for CNS candidiasis in patients with intracranial shunts.
- This biomarker-guided strategy enabled successful shunt reimplantation and long-term prevention of CNS candidiasis recurrence.
- The child remained free of CNS candidiasis for 19 months post-treatment, underscoring the efficacy of BDG-guided therapy.
More Related Videos
08:31Candida albicans Biofilm Development on Medically-relevant Foreign Bodies in a Mouse Subcutaneous Model Followed by Bioluminescence Imaging
Published on: January 27, 2015
10:02Isolation and Purification of Fungal β-Glucan as an Immunotherapy Strategy for Glioblastoma
Published on: June 2, 2023
