Cryptococcal Meningitis Diagnostics and Screening in the Era of Point-of-Care Laboratory Testing

Over the past ten years, standard diagnostics for cryptococcal meningitis in HIV-infected persons have evolved from culture to India ink to detection of cryptococcal antigen (CrAg), with the recent development and distribution of a point-of-care lateral flow assay. This assay is highly sensitive and...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical microbiology 2019-01, Vol.57 (1)
Main Authors: Rajasingham, Radha, Wake, Rachel M, Beyene, Tafese, Katende, Andrew, Letang, Emilio, Boulware, David R
Format: Article
Language:English
Subjects:
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - microbiology
AIDS-Related Opportunistic Infections - mortality
AIDS-Related Opportunistic Infections - prevention & control
Antigens, Fungal - blood
Antigens, Fungal - cerebrospinal fluid
Asymptomatic Infections
Bacteriological Techniques
Cryptococcus - immunology
Humans
Mass Screening
Meningitis, Cryptococcal - diagnosis
Meningitis, Cryptococcal - microbiology
Meningitis, Cryptococcal - mortality
Meningitis, Cryptococcal - prevention & control
Minireview
Point-of-Care Testing
Sensitivity and Specificity
Survival Rate
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Over the past ten years, standard diagnostics for cryptococcal meningitis in HIV-infected persons have evolved from culture to India ink to detection of cryptococcal antigen (CrAg), with the recent development and distribution of a point-of-care lateral flow assay. This assay is highly sensitive and specific in cerebrospinal fluid (CSF), but is also sensitive in the blood to detect CrAg prior to meningitis symptoms. CrAg screening of HIV-infected persons in the blood prior to development of fulminant meningitis and preemptive treatment for CrAg-positive persons are recommended by the World Health Organization and many national HIV guidelines. Thus, CrAg testing is occurring more widely, especially in resource-limited laboratory settings. CrAg titer predicts meningitis and death and could be used in the future to customize therapy according to burden of infection.
ISSN:0095-1137
1098-660X
DOI:10.1128/JCM.01238-18