Abstract
Background: Detection of antigen in BAL is useful for diagnosis of histoplasmosis. The MVista Histoplasma antigen enzyme immunoassay has been modified to permit quantification. The purpose of this study is to compare the sensitivity of the quantitative antigen detection assay with cytopathology and culture of BAL specimens. Methods: BAL from patients with histoplasmosis who were evaluated at the Indiana University Medical Center and controls without histoplasmosis were studied. BAL fluid was tested in the quantitative Histoplasma antigen assay. Results: Antigen was detected in the BAL in 93.5% of patients with histoplasmosis, 80% with blastomycosis, and 0% of controls with nonfungal infections. Antigen was detected in the urine of 79% and serum in 65% of patients with histoplasmosis. Cytopathology was positive in 48% and culture in 48% of patients with histoplasmosis, and 40% and 60% of patients with blastomycosis, respectively. Serology was positive in 65%. Combining BAL antigen detection and BAL cytopathology, both methods for rapid diagnosis, the sensitivity was 96.8% in histoplasmosis and 80% in blastomycosis. Conclusions: Detection of antigen in BAL complements antigen detection in serum and urine as an objective diagnostic test for histoplasmosis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 623-628 |
| Number of pages | 6 |
| Journal | Chest |
| Volume | 137 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2010 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
Cite this
Diagnosis of histoplasmosis by antigen detection in BAL fluid. / Hage, Chadi A.; Davis, Thomas E.; Fuller, Deanna; Egan, Lindsey; Witt, John R.; Wheat, L. Joseph; Knox, Kenneth S.
In: Chest, Vol. 137, No. 3, 01.03.2010, p. 623-628.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diagnosis of histoplasmosis by antigen detection in BAL fluid
AU - Hage, Chadi A.
AU - Davis, Thomas E.
AU - Fuller, Deanna
AU - Egan, Lindsey
AU - Witt, John R.
AU - Wheat, L. Joseph
AU - Knox, Kenneth S
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Background: Detection of antigen in BAL is useful for diagnosis of histoplasmosis. The MVista Histoplasma antigen enzyme immunoassay has been modified to permit quantification. The purpose of this study is to compare the sensitivity of the quantitative antigen detection assay with cytopathology and culture of BAL specimens. Methods: BAL from patients with histoplasmosis who were evaluated at the Indiana University Medical Center and controls without histoplasmosis were studied. BAL fluid was tested in the quantitative Histoplasma antigen assay. Results: Antigen was detected in the BAL in 93.5% of patients with histoplasmosis, 80% with blastomycosis, and 0% of controls with nonfungal infections. Antigen was detected in the urine of 79% and serum in 65% of patients with histoplasmosis. Cytopathology was positive in 48% and culture in 48% of patients with histoplasmosis, and 40% and 60% of patients with blastomycosis, respectively. Serology was positive in 65%. Combining BAL antigen detection and BAL cytopathology, both methods for rapid diagnosis, the sensitivity was 96.8% in histoplasmosis and 80% in blastomycosis. Conclusions: Detection of antigen in BAL complements antigen detection in serum and urine as an objective diagnostic test for histoplasmosis.
AB - Background: Detection of antigen in BAL is useful for diagnosis of histoplasmosis. The MVista Histoplasma antigen enzyme immunoassay has been modified to permit quantification. The purpose of this study is to compare the sensitivity of the quantitative antigen detection assay with cytopathology and culture of BAL specimens. Methods: BAL from patients with histoplasmosis who were evaluated at the Indiana University Medical Center and controls without histoplasmosis were studied. BAL fluid was tested in the quantitative Histoplasma antigen assay. Results: Antigen was detected in the BAL in 93.5% of patients with histoplasmosis, 80% with blastomycosis, and 0% of controls with nonfungal infections. Antigen was detected in the urine of 79% and serum in 65% of patients with histoplasmosis. Cytopathology was positive in 48% and culture in 48% of patients with histoplasmosis, and 40% and 60% of patients with blastomycosis, respectively. Serology was positive in 65%. Combining BAL antigen detection and BAL cytopathology, both methods for rapid diagnosis, the sensitivity was 96.8% in histoplasmosis and 80% in blastomycosis. Conclusions: Detection of antigen in BAL complements antigen detection in serum and urine as an objective diagnostic test for histoplasmosis.
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U2 - 10.1378/chest.09-1702
DO - 10.1378/chest.09-1702
M3 - Article
C2 - 19837826
AN - SCOPUS:77949517290
VL - 137
SP - 623
EP - 628
JO - Chest
JF - Chest
SN - 0012-3692
IS - 3
ER -