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Cerebrospinal Fluid (1,3)-Beta-D-Glucan Testing Is Useful in Diagnosis of Coccidioidal Meningitis David A. Stevens,a Yonglong Zhang,b Malcolm A. Finkelman,b Demosthenes Pappagianis,c Karl V. Clemons,a Marife Martineza Stanford University Medical School and California Institute Medical Research, San Jose, California, USAa; Associates of Cape Cod, Inc., Falmouth, Massachusetts, USAb; University of California, Davis, Davis, California, USAc
Diagnosing coccidioidal meningitis (CM) can be problematic owing to its infrequency and/or a delay in the positivity of a cerebrospinal fluid (CSF) culture or CSF antibody, particularly if the primary coccidioidal infection is unrecognized. We tested 37 CSF specimens, 26 from patients with confirmed CM and 11 from patients with suspected microbial meningitis without fungal diagnosis, for (1,3)-beta-glucan (BG). BG in CM CSF specimens ranged from 18 to 3,300 pg/ml and in controls ranged from 103 pg/ml were CM. The one false-negative specimen was from a patient with a pseudosyrinx, without inflammatory evidence of meningitis activity. Serial samples from some patients were positive at
Cerebrospinal Fluid (1,3)-Beta-D-Glucan Testing Is Useful in Diagnosis of Coccidioidal Meningitis David A. Stevens,a Yonglong Zhang,b Malcolm A. Finkelman,b Demosthenes Pappagianis,c Karl V. Clemons,a Marife Martineza Stanford University Medical School and California Institute Medical Research, San Jose, California, USAa; Associates of Cape Cod, Inc., Falmouth, Massachusetts, USAb; University of California, Davis, Davis, California, USAc
Diagnosing coccidioidal meningitis (CM) can be problematic owing to its infrequency and/or a delay in the positivity of a cerebrospinal fluid (CSF) culture or CSF antibody, particularly if the primary coccidioidal infection is unrecognized. We tested 37 CSF specimens, 26 from patients with confirmed CM and 11 from patients with suspected microbial meningitis without fungal diagnosis, for (1,3)-beta-glucan (BG). BG in CM CSF specimens ranged from 18 to 3,300 pg/ml and in controls ranged from 103 pg/ml were CM. The one false-negative specimen was from a patient with a pseudosyrinx, without inflammatory evidence of meningitis activity. Serial samples from some patients were positive at
