Cryptococcosis other diagnostic studies: Difference between revisions
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==Other Diagnostic studies== | ==Other Diagnostic studies== | ||
*India ink or fungal wet mount of [[CSF]] will demonstrate a ([[Yeast|budding yeast]]). | |||
*[[Mucicarmine]] stain provides specific staining of the [[polysaccharide]] cell wall. | |||
*[[Antigen]] detection in [[CSF]] is useful for the diagnosis of cryptococcal meningitis. | |||
Fungal meningitis may be differentiated from other causes of [[meningitis]] by [[cerebrospinal fluid]] examination as shown below:<ref name="pmid23717798">{{cite journal| author=Le Rhun E, Taillibert S, Chamberlain MC| title=Carcinomatous meningitis: Leptomeningeal metastases in solid tumors. | journal=Surg Neurol Int | year= 2013 | volume= 4 | issue= Suppl 4 | pages= S265-88 | pmid=23717798 | doi=10.4103/2152-7806.111304 | pmc=3656567 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23717798 }} </ref><ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618 }} </ref><ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096 }} </ref><ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948 }} </ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819 }} </ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
|+ | |||
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Cerebrospinal fluid level}} | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Normal level}} | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Bacterial meningitis}}<ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948 }} </ref> | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Viral meningitis}}<ref name="pmid10654948">{{cite journal| author=Negrini B, Kelleher KJ, Wald ER| title=Cerebrospinal fluid findings in aseptic versus bacterial meningitis. | journal=Pediatrics | year= 2000 | volume= 105 | issue= 2 | pages= 316-9 | pmid=10654948 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10654948 }} </ref> | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Fungal meningitis}} | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Tuberculous meningitis}}<ref name="pmid20146981">{{cite journal| author=Caudie C, Tholance Y, Quadrio I, Peysson S| title=[Contribution of CSF analysis to diagnosis and follow-up of tuberculous meningitis]. | journal=Ann Biol Clin (Paris) | year= 2010 | volume= 68 | issue= 1 | pages= 107-11 | pmid=20146981 | doi=10.1684/abc.2010.0407 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20146981 }} </ref> | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Malignant meningitis}}<ref name="pmid23717798">{{cite journal| author=Le Rhun E, Taillibert S, Chamberlain MC| title=Carcinomatous meningitis: Leptomeningeal metastases in solid tumors. | journal=Surg Neurol Int | year= 2013 | volume= 4 | issue= Suppl 4 | pages= S265-88 | pmid=23717798 | doi=10.4103/2152-7806.111304 | pmc=3656567 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23717798 }} </ref> | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Cells/ul''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''< 5''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''>300''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''10-1000''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''10-500''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''50-500''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''>4''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''Cells''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte]]:[[Monocyte]] 7:3''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Granulocyte]] > [[Lymphocyte]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte]] > [[Granulocyte]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte|Lympho]].>[[Granulocyte]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte|Lymphocytes]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Lymphocyte|Lymphocytes]]''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''Total [[protein]] (mg/dl''') | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''45-60''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''Typically 100-500''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | '''Normal or slightly high''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''High''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''Typically 100-200''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''>50''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Glucose]] ratio ([[CSF]]/[[Plasma|plasma)]]<ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618 }} </ref>''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''> 0.5''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''< 0.3''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''> 0.6''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''<0.3''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''< 0.5''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''<0.5''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Lactate]] (mmols/l)<ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096 }} </ref>''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''< 2.1''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''> 2.1''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''< 2.1''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''>3.2''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''> 2.1''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''>2.1''' | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''Others''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''ICP:6-12 (cm H2O)''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Gram stain|CSF gram stain]], [[Culture medium|CSF culture]], [[CSF]] [[Antigen|bacterial antigen]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[PCR]] of [[HSV|HSV-DNA]], [[VZV]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[Gram stain|CSF gram stain]], CSF india ink''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[PCR]] of TBC-[[DNA]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |'''[[CSF]] [[tumor markers]] such as [[Alpha fetoprotein|alpha fetoproteins]], [[CEA]]''' | |||
|- | |||
|} | |||
==Gallery== | ==Gallery== | ||
Revision as of 15:43, 5 June 2017
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Cryptococcosis Microchapters |
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Treatment |
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Case Studies |
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Cryptococcosis other diagnostic studies On the Web |
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American Roentgen Ray Society Images of Cryptococcosis other diagnostic studies |
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Risk calculators and risk factors for Cryptococcosis other diagnostic studies |
Other Diagnostic studies
- India ink or fungal wet mount of CSF will demonstrate a (budding yeast).
- Mucicarmine stain provides specific staining of the polysaccharide cell wall.
- Antigen detection in CSF is useful for the diagnosis of cryptococcal meningitis.
Fungal meningitis may be differentiated from other causes of meningitis by cerebrospinal fluid examination as shown below:[1][2][3][4][5]
| Cerebrospinal fluid level | Normal level | Bacterial meningitis[4] | Viral meningitis[4] | Fungal meningitis | Tuberculous meningitis[6] | Malignant meningitis[1] |
|---|---|---|---|---|---|---|
| Cells/ul | < 5 | >300 | 10-1000 | 10-500 | 50-500 | >4 |
| Cells | Lymphocyte:Monocyte 7:3 | Granulocyte > Lymphocyte | Lymphocyte > Granulocyte | Lympho.>Granulocyte | Lymphocytes | Lymphocytes |
| Total protein (mg/dl) | 45-60 | Typically 100-500 | Normal or slightly high | High | Typically 100-200 | >50 |
| Glucose ratio (CSF/plasma)[2] | > 0.5 | < 0.3 | > 0.6 | <0.3 | < 0.5 | <0.5 |
| Lactate (mmols/l)[3] | < 2.1 | > 2.1 | < 2.1 | >3.2 | > 2.1 | >2.1 |
| Others | ICP:6-12 (cm H2O) | CSF gram stain, CSF culture, CSF bacterial antigen | PCR of HSV-DNA, VZV | CSF gram stain, CSF india ink | PCR of TBC-DNA | CSF tumor markers such as alpha fetoproteins, CEA |
Gallery
-
![Cryptococcosis of lung in patient with AIDS. From Public Health Image Library (PHIL). [7]](/images/0/09/Cryptococcosis21.jpeg)
Cryptococcosis of lung in patient with AIDS. From Public Health Image Library (PHIL). [7] -
![Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). [7]](/images/7/70/Cryptococcosis20.jpeg)
Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). [7] -
![Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). [7]](/images/0/0c/Cryptococcosis19.jpeg)
Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). [7] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). [7]](/images/a/a3/Cryptococcosis18.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). [7] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [7]](/images/b/bd/Cryptococcosis17.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [7] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [7]](/images/5/56/Cryptococcosis16.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [7] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using GMS stain. From Public Health Image Library (PHIL). [7]](/images/8/8f/Cryptococcosis15.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using GMS stain. From Public Health Image Library (PHIL). [7] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using Mucicarmine stain. From Public Health Image Library (PHIL). [7]](/images/7/72/Cryptococcosis14.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using Mucicarmine stain. From Public Health Image Library (PHIL). [7] -
![Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). [7]](/images/7/79/Cryptococcosis12.jpeg)
Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). [7] -
![Cryptococcus neoformans fungi from a liver specimen, and stained using the periodic acid-Schiff staining technique (980X mag). From Public Health Image Library (PHIL). [7]](/images/a/af/Cryptococcosis09.jpeg)
Cryptococcus neoformans fungi from a liver specimen, and stained using the periodic acid-Schiff staining technique (980X mag). From Public Health Image Library (PHIL). [7] -
![Methenamine silver-stained photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800X mag). From Public Health Image Library (PHIL). [7]](/images/a/a1/Cryptococcosis07.jpeg)
Methenamine silver-stained photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800X mag). From Public Health Image Library (PHIL). [7] -
![Photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800x mag). From Public Health Image Library (PHIL). [7]](/images/9/9e/Cryptococcosis06.jpeg)
Photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800x mag). From Public Health Image Library (PHIL). [7] -
![Periodic acid-Schiff-stained photomicrograph revealed some of the histopathologic details associated with a disseminated Cryptococcus sp. infection involving the liver (980x mag). From Public Health Image Library (PHIL). [7]](/images/8/83/Cryptococcosis03.jpeg)
Periodic acid-Schiff-stained photomicrograph revealed some of the histopathologic details associated with a disseminated Cryptococcus sp. infection involving the liver (980x mag). From Public Health Image Library (PHIL). [7]
![Cryptococcosis of lung in patient with AIDS. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis21.jpeg)
![Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis20.jpeg)
![Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis19.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis18.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis17.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis16.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using GMS stain. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis15.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using Mucicarmine stain. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis14.jpeg)
![Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis12.jpeg)
![Cryptococcus neoformans fungi from a liver specimen, and stained using the periodic acid-Schiff staining technique (980X mag). From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis09.jpeg)
![Methenamine silver-stained photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800X mag). From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis07.jpeg)
![Photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800x mag). From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis06.jpeg)
![Periodic acid-Schiff-stained photomicrograph revealed some of the histopathologic details associated with a disseminated Cryptococcus sp. infection involving the liver (980x mag). From Public Health Image Library (PHIL). [7]](/index.php/File:Cryptococcosis03.jpeg)
References
- ↑ 1.0 1.1 Le Rhun E, Taillibert S, Chamberlain MC (2013). "Carcinomatous meningitis: Leptomeningeal metastases in solid tumors". Surg Neurol Int. 4 (Suppl 4): S265–88. doi:10.4103/2152-7806.111304. PMC 3656567. PMID 23717798.
- ↑ 2.0 2.1 Chow E, Troy SB (2014). "The differential diagnosis of hypoglycorrhachia in adult patients". Am J Med Sci. 348 (3): 186–90. doi:10.1097/MAJ.0000000000000217. PMC 4065645. PMID 24326618.
- ↑ 3.0 3.1 Leen WG, Willemsen MA, Wevers RA, Verbeek MM (2012). "Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice". PLoS One. 7 (8): e42745. doi:10.1371/journal.pone.0042745. PMC 3412827. PMID 22880096.
- ↑ 4.0 4.1 4.2 Negrini B, Kelleher KJ, Wald ER (2000). "Cerebrospinal fluid findings in aseptic versus bacterial meningitis". Pediatrics. 105 (2): 316–9. PMID 10654948.
- ↑ Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.
- ↑ Caudie C, Tholance Y, Quadrio I, Peysson S (2010). "[Contribution of CSF analysis to diagnosis and follow-up of tuberculous meningitis]". Ann Biol Clin (Paris). 68 (1): 107–11. doi:10.1684/abc.2010.0407. PMID 20146981.
- ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 7.12 "Public Health Image Library (PHIL)".