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Pseudooutbreak of cryptococcal meningitis

R L Hopfer, R L Katz, V Fainstein

    Journal of Clinical Microbiology
    |June 1, 1982
    PubMed
    Summary
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    A pseudooutbreak of cryptococcal meningitis occurred due to contaminated albumin used for Papanicolaou-stained slides. Cryptococcus neoformans was identified in specimens and the albumin solution, highlighting a critical laboratory contamination issue.

    Area of Science:

    • Clinical Microbiology
    • Infectious Diseases
    • Laboratory Diagnostics

    Background:

    • Cryptococcal meningitis is a serious fungal infection, particularly in immunocompromised individuals.
    • Accurate laboratory diagnosis of fungal meningitis is crucial for timely treatment.
    • Contamination in laboratory reagents can lead to diagnostic errors and pseudooutbreaks.

    Purpose of the Study:

    • To investigate the cause of a pseudooutbreak of cryptococcal meningitis.
    • To identify the source of Cryptococcus neoformans contamination in cerebrospinal fluid specimens.
    • To evaluate diagnostic methods for cryptococcal meningitis in the context of reagent contamination.

    Main Methods:

    • Microscopic examination of cerebrospinal fluid (CSF) using cytocentrifuge and India ink preparations.

    Related Experiment Videos

  • Cryptococcal antigen testing on CSF specimens.
  • Culture of CSF and albumin solution for fungal identification.
  • Review of laboratory procedures for Papanicolaou staining.

    • Main Results:

    • Organisms consistent with Cryptococcus neoformans were observed in cytocentrifuge preparations of CSF.
    • India ink preparations of CSF were negative for fungal elements.
    • Cryptococcal antigen tests on CSF were positive.
    • Cryptococcus neoformans was successfully cultured from both CSF specimens and the albumin solution used in slide preparation.

    Conclusions:

    • Contaminated albumin solution used in Papanicolaou staining was the source of Cryptococcus neoformans contamination.
    • This contamination led to a pseudooutbreak of cryptococcal meningitis.
    • Laboratory vigilance and quality control of reagents are essential to prevent diagnostic errors and false outbreaks.