Markedly Elevated Serum Lactate Dehydrogenase Levels Are a Clue to the Diagnosis of Disseminated Histoplasmosis in Patients with AIDS

Disseminated histoplasmosis is a common late manifestation of AIDS, but the diagnosis may be unsuspected in some patients because the clinical presentation of histoplasmosis may mimic other opportunistic infections. High serum lactate dehydrogenase (LDH) levels have been associated with disseminated...

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Bibliographic Details
Published in:Clinical infectious diseases 1997-05, Vol.24 (5), p.942-944
Main Authors: Corcoran, Gavin R., Al-Abdely, Hail, Flanders, Christopher D., Geimer, Jone, Patterson, Thomas F.
Format: Article
Language:English
Subjects:
AIDS
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - enzymology
AIDS/HIV
Antigens
Biological and medical sciences
Biomarkers - blood
Blood
Clinical Articles
Dehydrogenases
Fungemia - diagnosis
Fungemia - enzymology
Histoplasma
Histoplasmosis
Histoplasmosis - diagnosis
Histoplasmosis - enzymology
Hospital admissions
human immunodeficiency virus
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
L-Lactate Dehydrogenase - blood
Lactates
Medical sciences
Mortality
Odds Ratio
Sensitivity and Specificity
Survival Rate
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Summary:Disseminated histoplasmosis is a common late manifestation of AIDS, but the diagnosis may be unsuspected in some patients because the clinical presentation of histoplasmosis may mimic other opportunistic infections. High serum lactate dehydrogenase (LDH) levels have been associated with disseminated histoplasmosis. We therefore evaluated whether markedly increased LDH levels were useful for making a diagnosis of disseminated histoplasmosis by comparing admission LDH levels for 15 patients with culture-proven disseminated histoplasmosis with those for 30 patients with advanced AIDS who were admitted to the hospital for evaluation of pulmonary infiltrates and fever. The mean admission LDH level in patients with disseminated histoplasmosis was 1,356 IU/L (range, 145–5,410 IU) whereas it was 332 (range, 77–832 IU) in the patients with other pulmonary processes. Admission LDH levels were >600 IU in 11 (73%) of the 15 patients with disseminated histoplasmosis vs. 3 (10%) of controls (P < .001). We conclude that markedly elevated admission LDH levels may be a clinical clue to the diagnosis of disseminated histoplasmosis in patients with AIDS.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/24.5.942