ß-D-Glucan Assay in the Cerebrospinal Fluid for the Diagnosis of Non-cryptococcal Fungal Infection of the Central Nervous System: A Retrospective Multicentric Analysis and a Comprehensive Review of the Literature

Resource type
Journal Article
Authors/contributors
Title
ß-D-Glucan Assay in the Cerebrospinal Fluid for the Diagnosis of Non-cryptococcal Fungal Infection of the Central Nervous System: A Retrospective Multicentric Analysis and a Comprehensive Review of the Literature
Abstract
Background. Except for cryptococcosis, fungal infection of the central nervous system (FI-CNS) is a rare but severe complication. Clinical and radiological signs are non-specific, and the value of conventional mycological diagnosis is very low. This study aimed to assess the value of β1,3-D-glucan (BDG) detection in the cerebrospinal fluid (CSF) of non-neonatal noncryptococcosis patients. Methods. Cases associated with BDG assay in the CSF performed in 3 French University Hospitals over 5 years were included. Clinical, radiological, and mycological results were used to classify the episodes as proven/highly probable, probable, excluded, and unclassified FI-CNS. Sensitivity and specificity were compared to that calculated from an exhaustive review of the literature. Results. In total, 228 episodes consisting of 4, 7, 177, and 40 proven/highly probable, probable, excluded, and unclassified FICNS, respectively, were analysed. The sensitivity of BDG assay in CSF to diagnose proven/highly probable/probable FI-CNS ranged from 72.7% [95% confidence interval {CI}: 43.4%‒90.2%] to 100% [95% CI: 51%‒100%] in our study and was 82% in the literature. For the first time, specificity could be calculated over a large panel of pertinent controls and was found at 81.8% [95% CI: 75.3%‒86.8%]. Bacterial neurologic infections were associated with several false positive results Conclusions. Despite its sub-optimal performance, BDG assay in the CSF should be added to the diagnostic armamentarium for FI-CNS.
Publication
Clinical Infectious Diseases
Date
2023-09-11
Volume
77
Issue
5
Pages
711-720
Accessed
2/29/24, 5:05 PM
ISSN
1058-4838, 1537-6591
Short Title
ß-D-Glucan Assay in the Cerebrospinal Fluid for the Diagnosis of Non-cryptococcal Fungal Infection of the Central Nervous System
Language
en
Library Catalog
DOI.org (Crossref)
Citation
Bigot, J., Leroy, J., Chouaki, T., Cholley, L., Bigé, N., Tabone, M.-D., Brissot, E., Thorez, S., Maizel, J., Dupont, H., Sendid, B., Hennequin, C., & Guitard, J. (2023). ß-D-Glucan Assay in the Cerebrospinal Fluid for the Diagnosis of Non-cryptococcal Fungal Infection of the Central Nervous System: A Retrospective Multicentric Analysis and a Comprehensive Review of the Literature. Clinical Infectious Diseases, 77(5), 711–720. https://doi.org/10.1093/cid/ciad274
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