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Published on: March 22, 2012
Diagnosis of histoplasmosis by antigen detection during an outbreak in Indianapolis, Ind
B Williams1, M Fojtasek, P Connolly-Stringfield
1Department of Dermatology, Indiana University School of Medicine.
Abstract:
In this study we examine the sensitivity of Histoplasma capsulatum var capsulatum antigen detection for the diagnosis of histoplasmosis. This was a retrospective review of the sensitivity of antigen detection in patients who were diagnosed as having self-limited, chronic pulmonary, or disseminated histoplasmosis during an outbreak in Indianapolis, Ind. All patients had clinical and laboratory evidence of histoplasmosis, and specimens of urine or serum that were obtained from the patients were tested for H capsulatum var capsulatum antigen. Of the 195 patients who were studied, the following forms of the infection were found: disseminated (n = 108), self-limited (n = 70), chronic pulmonary (n = 14), and asymptomatic (n = 3). Antigen was detected in 92%, 21%, and 39% of the patients with the disseminated, chronic pulmonary, and self-limited forms of histoplasmosis, respectively. Tests for the antigen are most useful in patients with clinical findings of disseminated infection. Antigen detection also may be useful in those patients with more severe pulmonary involvement, especially during the first month of illness when serologic tests for antibodies may be negative.
Insights
Histoplasma capsulatum var capsulatum antigen detection is highly sensitive for disseminated histoplasmosis. This diagnostic method is less sensitive for self-limited or chronic pulmonary forms of the fungal infection.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Histoplasmosis is a fungal infection caused by Histoplasma capsulatum.
- Accurate and timely diagnosis is crucial for effective treatment.
- Antigen detection offers a potential diagnostic tool for histoplasmosis.
Purpose of the Study:
- To evaluate the sensitivity of Histoplasma capsulatum var capsulatum antigen detection.
- To assess the utility of antigen detection across different forms of histoplasmosis.
- To determine the optimal use cases for antigen detection in diagnosing histoplasmosis.
Main Methods:
- Retrospective review of patient data.
- Analysis of urine or serum specimens for H. capsulatum antigen.
- Inclusion of patients with diagnosed disseminated, chronic pulmonary, and self-limited histoplasmosis.
Main Results:
- Antigen detection sensitivity was 92% for disseminated histoplasmosis.
- Sensitivity was 21% for chronic pulmonary and 39% for self-limited forms.
- Antigen detection is most valuable in disseminated and severe pulmonary cases.
Conclusions:
- Histoplasma antigen detection is highly sensitive for disseminated histoplasmosis.
- The test shows lower sensitivity for less severe or chronic pulmonary forms.
- Antigen testing is most beneficial for disseminated infections and early severe pulmonary disease.
