Pseudooutbreak of cryptococcal meningitis
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Updated: Nov 5, 2026
10:02
Visualizing Non-lytic Exocytosis of Cryptococcus neoformans from Macrophages Using Digital Light Microscopy
Published on: October 21, 2014
Journal of Clinical Microbiology
|June 1, 1982
Abstract:
A pseudooutbreak of cryptococcal meningitis was caused by the use of contaminated albumin solution used in the preparation of Papanicolaou-stained slides of cerebrospinal fluid. Organisms were seen in cytocentrifuge preparations, but not in India ink preparations of cerebrospinal fluid specimens. Cryptococcal antigen tests were positive and Cryptococcus neoformans was cultured from the albumin-treated cerebrospinal fluid specimens and from the albumin solution.
Insights
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.
- 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.
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