Cryptococcosis laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D.; Yazan Daaboul, M.D.

Laboratory Findings

Detection of cryptococcal antigen (capsular material) by culture of CSF, sputum and urine provides definitive diagnosis.

Culture

• The gold standard for diagnosing cryptococcal infection; culture is traditionally identify Cryptococcus from human body samples.
• Blood cultures may be positive in heavy infections.

Microscopy

• India Ink can be performed on CSF to quickly visualize Cryptococcus cells under a microscope; however, it can have limited sensitivity.
• Histopathology for detection of narrow-based budding yeasts in tissue can also be used.

Antigen detection

• Antigen detection can be used on CSF or serum for detection of early, asymptomatic cryptococcal infection in HIV-infected patients.
• It has a higher sensitivity than microscopy or culture.
• Techniques used include:

• Latex agglutination (LA)
• Enzyme immunoassay (EIA)
• Lateral flow assay (LFA)