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Correlation between serum cryptococcal antigen titre and meningitis in immunocompetent patients

Ian Gassiep1,2, Chaw Aye3, Mark Armstrong2,1

  • 12​School of Medicine, James Cook University, Douglas 4814, Australia.

Journal of Medical Microbiology
|August 24, 2018
PubMed

Insights

Higher serum cryptococcal antigen (CRAG) levels correlate with cryptococcal meningitis in immunocompetent individuals. This finding aids diagnosis, especially in resource-limited settings.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Immunology

Background:

  • Cryptococcal meningitis is a serious infection, particularly in immunocompromised individuals.
  • Diagnosis in immunocompetent patients can be challenging.
  • Serum cryptococcal antigen (CRAG) is a key diagnostic marker.

Purpose of the Study:

  • To determine the correlation between serum CRAG levels and the diagnosis of cryptococcal meningitis.
  • To evaluate the utility of serum CRAG in immunocompetent patients.
  • To assess the diagnostic value of serum CRAG in specific clinical scenarios.

Main Methods:

  • Retrospective multicentre analysis of immunocompetent patients diagnosed with cryptococcal meningitis (2000-2017).
  • Comparison of serum CRAG titres between meningitis and non-meningitis patient groups.
  • Calculation of relative risk for meningitis based on serum CRAG levels.

Main Results:

  • Serum CRAG titres were significantly higher in patients with meningitis (1:256) compared to non-meningitis cases (1:64) (P=0.012).
  • A serum CRAG titre >1:64 indicated a 1.8-fold increased relative risk of meningitis.
  • A clear correlation was established between serum CRAG titre and meningitis diagnosis.

Conclusions:

  • Serum CRAG titre shows a significant correlation with cryptococcal meningitis in immunocompetent patients.
  • Elevated serum CRAG may assist in diagnosing meningitis, particularly when lumbar puncture is not feasible.
  • This evidence supports the use of serum CRAG in guiding therapeutic decisions in resource-limited settings.

Keywords:
cryptococcal antigencryptococcal meningitiscryptococcosisimmunocompetent

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