Positive (1-3) B-d-Glucan and cross reactivity of fungal assays in coccidioidomycosis

Tirdad T. Zangeneh, Joshua Malo, Carmen Luraschi-Monjagatta, Chadi A. Hage, L. Joseph Wheat, Christopher Strawter, Stephen A. Klotz, Kenneth S. Knox

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Fungal antigen testing in immunosuppressed patients has emerged as a powerful diagnostic tool. Some assays are relatively nonspecific, and misinterpretation can have severe clinical consequences. Additionally, when new assays become commercially available it is important to evaluate the potential for cross reactivity. We recently observed several immunosuppressed patients with positive (1→3)-β-D-glucan (BG) who were eventually diagnosed with coccidioidomycosis in the endemic area of Tucson, Arizona. Although the BG assay is known to detect glucans of many fungal pathogens, reports of cross-reactivity with Coccidioides remain sparsely reported. To test the cross-reactivity of fungal antigens in detection assays, serum samples from patients with coccidioidomycosis testing positive for Coccidioides antigen were evaluated for BG. Of 12 samples positive for Coccidioides antigen (≥ 0.07 ng/ml), 11 (92%) were positive by BG (>80 pg/ml), and of 11 positive for Aspergillus galactomannan, 10 (91%) were positive by BG (>80 pg/ml). We conclude that the BG assay is nonspecific, detecting glucans from many fungal pathogens, including Coccidioides. In the endemic area, a positive BG warrants further specific testing.

Original languageEnglish (US)
Pages (from-to)171-173
Number of pages3
JournalMedical mycology
Volume53
Issue number2
DOIs
StatePublished - Oct 18 2015

Keywords

  • Coccidioidomycosis
  • galactomannan
  • glucan
  • immunoassay

ASJC Scopus subject areas

  • Infectious Diseases

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