Diane Libert1, Gary W Procop2, Mohammad Q Ansari3. 1. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. 2. Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH. 3. Department of Pathology and Laboratory Medicine, Cleveland Veterans Affairs Medical Center, Cleveland, OH.
Abstract
OBJECTIVES: Serum and urine antigen (SAg, UAg) detection are common tests for Histoplasma capsulatum. UAg detection is more widely used and reportedly has a higher sensitivity. We investigated whether SAg detection contributes meaningfully to the initial evaluation of patients with suspected histoplasmosis. METHODS: We reviewed 20,285 UAg and 1,426 SAg tests ordered from 1997 to 2016 and analyzed paired UAg and SAg tests completed on the same patient within 1 week. We determined the positivity rate for each test. RESULTS: Of 601 paired specimens, 542 were concurrent negatives and 48 were concurrent positives (98% agreement). Medical records were available for eight of 11 pairs with discrepant results. UAg was falsely positive in six instances, truly positive once, and falsely negative once. CONCLUSIONS: These findings support using a single antigen detection test, rather than both UAg and SAg, as an initial screen for suspected histoplasmosis. This aligns with the current practice of most physicians.
OBJECTIVES: Serum and urine antigen (SAg, UAg) detection are common tests for Histoplasma capsulatum. UAg detection is more widely used and reportedly has a higher sensitivity. We investigated whether SAg detection contributes meaningfully to the initial evaluation of patients with suspected histoplasmosis. METHODS: We reviewed 20,285 UAg and 1,426 SAg tests ordered from 1997 to 2016 and analyzed paired UAg and SAg tests completed on the same patient within 1 week. We determined the positivity rate for each test. RESULTS: Of 601 paired specimens, 542 were concurrent negatives and 48 were concurrent positives (98% agreement). Medical records were available for eight of 11 pairs with discrepant results. UAg was falsely positive in six instances, truly positive once, and falsely negative once. CONCLUSIONS: These findings support using a single antigen detection test, rather than both UAg and SAg, as an initial screen for suspected histoplasmosis. This aligns with the current practice of most physicians.
Authors: George R Thompson; David R Boulware; Nathan C Bahr; Cornelius J Clancy; Thomas S Harrison; Carol A Kauffman; Thuy Le; Marisa H Miceli; Eleftherios Mylonakis; M Hong Nguyen; Luis Ostrosky-Zeichner; Thomas F Patterson; John R Perfect; Andrej Spec; Dimitrios P Kontoyiannis; Peter G Pappas Journal: Open Forum Infect Dis Date: 2022-03-04 Impact factor: 4.423
Authors: Sean X Zhang; N Esther Babady; Kimberly E Hanson; Amanda T Harrington; Paige M K Larkin; Sixto M Leal; Paul M Luethy; Isabella W Martin; Preeti Pancholi; Gary W Procop; Stefan Riedel; Seyedmojtaba Seyedmousavi; Kaede V Sullivan; Thomas J Walsh; Shawn R Lockhart Journal: J Clin Microbiol Date: 2021-06-18 Impact factor: 5.948
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