HIV阴性患者的隐球菌病可能是机会性或地方病。尚未发表有关使用手指刺破全血(即时护理)隐球菌抗原侧流测定(CrAgLFA)诊断HIV阴性患者隐球菌病的研究。我们在圣保罗的两个中心进行了HIV阴性隐球菌病患者的病例系列研究,巴西。目的是确定手指刺破的全血CrAgLFA的敏感性,并描述该人群的主要特征。我们确定了30例HIV阴性隐球菌病患者[19例(63%),男性;中位年龄,47年]。10例(33%)患者免疫抑制,十个(33%)有其他合并症,和10(33%)明显有免疫能力,没有合并症。隐球菌病的部位分布如下:中枢神经系统,90%(n=27);肺,43%(n=13);和其他肺外部位,40%(n=12)。指刺全血CrAgLFA诊断隐球菌病的敏感性为97%(29/30)。在26名隐球菌性脑膜炎患者中,检测脑脊液的敏感性如下:CrAg乳胶凝集,77%(20/26);CrAgLFA,96%(25/26);和文化,81%(21/26)。培养物种在16例(62%)病例中鉴定出加蒂隐球菌,所有的人都有一个阳性的手指刺破全血CrAgLFA。该测试对HIV阴性患者的隐球菌病的诊断具有很高的敏感性,包括那些由C.Gattii引起的.
Cryptococcosis in HIV-negative patients can be an opportunistic or endemic disease. There are no published studies on the use of the finger-prick whole blood (point-of-care) cryptococcal antigen lateral flow assay (CrAg LFA) for diagnosing cryptococcosis in HIV-negative patients. We conducted a
case series study of HIV-negative patients with cryptococcosis in two centers in São Paulo, Brazil. The objectives were to identify the sensitivity of a finger-prick whole blood CrAg LFA and to describe the main characteristics of this population. We identified 30 HIV-negative patients with cryptococcosis [19 (63%), male; median age, 47 years]. Ten (33%) patients were immunosuppressed, ten (33%) had other comorbidities, and ten (33%) were apparently immunocompetent and without comorbidities. The distribution of the sites of cryptococcosis was as follows: the central nervous system, 90% (n = 27); pulmonary, 43% (n = 13); and other extrapulmonary sites, 40% (n = 12). The sensitivity of the finger-prick whole blood CrAg LFA for the diagnosis of cryptococcosis was 97% (29/30). Among 26 participants with cryptococcal meningitis, the sensitivity of testing cerebrospinal fluid was as follows: CrAg latex agglutination, 77% (20/26); CrAg LFA, 96% (25/26); and culture, 81% (21/26). Culture speciation identified Cryptococcus gattii in 16 (62%) cases, and all had a positive finger-prick whole blood CrAg LFA. This test presented high sensitivity to the diagnosis of cryptococcosis in HIV-negative patients, including those caused by C. gattii.