Serology of Human Cryptococcosis
Authors: DARRYL D. BINDSCHADLER
Journal: Annals of Internal Medicine (1968)

Article1 July 1968Serology of Human CryptococcosisDARRYL D. BINDSCHADLER, M.D., JOHN E. BENNETT, M.D., F.A.C.P.DARRYL D. BINDSCHADLER, M.D., JOHN E. BENNETT, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-69-1-45 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSixty-nine patients with cryptococcal meningoencephalitis and six patients with nonmeningeal cryptococcosis were studied serologically. Twenty-nine of the 75 patients had serum anticryptococcal antibody by an indirect fluorescence test (IFA). Titers ranged from 1:1 to 1:32. Forty-seven patients had cryptococcal antigen in serum or cerebrospinal fluid (CSF) detected by a complement fixation (CF) test. Of the 47, 7 also had serum antibody. Antigen titers ranged from 1:1 to 1:2048 in CSF and from 1:4 to 1:512 in serum. Only six patients, four with cryptococcal meningoencephalitis, were negative to both serologic tests.Among the patients with cryptococcal meningoencephalitis, those with Cryptococcus in india ink smears of CSF usually had cryptococcal antigen in blood, CSF, or both. Patients with negative india ink smears despite positive CSF cultures tended to have serum anticryptococcal antibody. The patients with anticryptococcal antibody were generally less ill than those with antigen and obtained a better response to therapy with amphotericin B.Although the CF test for antigen has been specific for cryptococcosis, a few false-positive tests for antibody were found. Among 253 control sera, 1.6% were IFA positive, as were sera from 6% of blastomycosis patients and from 12% of histoplasmosis patients. A cryptococcal skin test was also noted to produce false-positive IFA reactions in 31% of 48 patients and could create errors in serologic diagnosis.The two serologic tests used together have sufficient specificity and sensitivity to be a useful aid in the rapid diagnosis of cryptococcosis....References1. KAUFMAN L: Serology of systemic fungus diseases. Public Health Rep. 81: 177, 1966. CrossrefMedlineGoogle Scholar2. KIMBALLHASENCLEVERWOLFF HRHFSM: Detection of circulating antibody in human cryptococcosis by means of a bentonite flocculation technique. Amer. Rev. Resp. Dis. 95: 631, 1967. MedlineGoogle Scholar3. GORDONVEDDER MADK: Serologic tests in diagnosis and prognosis of cryptococcosis. JAMA 197: 961, 1966. CrossrefMedlineGoogle Scholar4. ATKINSONBENNETT AJJE: Experience with a new skin test antigen from Cryptococcus neoformans. Amer. Rev. Resp. Dis. 97: 637, 1968. MedlineGoogle Scholar5. WILSONBENNETTBAILEY DEJEJW: Serologic grouping of Cryptococcus neoformans. Proc. Soc. Exp. Biol. Med. In press. Google Scholar6. BENNETTHASENCLEVER JEHF: Cryptococcus neoformans polysaccharide: studies of serologic properties and role in infection. J. Immun. 94: 916, 1965. MedlineGoogle Scholar7. BENNETTHASENCLEVERTYNES JEHFBS: Detection of cryptococcal polysaccharide in serum and spinal fluid: value in diagnosis and prognosis. Trans. Ass. Amer. Physicians 77: 145, 1964. MedlineGoogle Scholar8. VOGEL RA: The indirect fluorescent antibody test for the detection of antibody in human cryptococcal disease. J. Infect. Dis. 116: 573, 1966. CrossrefMedlineGoogle Scholar9. POLLOCKWARD AQLM: A hemagglutination test for cryptococcosis. Amer. J. Med. 32: 6, 1962. CrossrefMedlineGoogle Scholar10. CAMPBELLHILL CCGB: Further studies on the development of complement-fixing antibodies and precipitins in healthy histoplasmin-sensitive persons following a single histoplasmin skin test. Amer. Rev. Resp. Dis. 90: 927, 1964. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, MarylandFrom the National Institute of Allergy and Infectious Diseases, Laboratory of Clinical Investigations, Infectious Disease Section, National Institutes of Health, Bethesda, Md.Requests for reprints should be addressed to John E. Bennett, M.D., Clinical Center, Room 11N-210, National Institutes of Health, Bethesda, Md. 20014. 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