Cryptococcosis other diagnostic studies: Difference between revisions
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*[[Antigen]] detection in [[CSF]] is useful for the diagnosis of cryptococcal meningitis. | *[[Antigen]] detection in [[CSF]] is useful for the diagnosis of cryptococcal meningitis. | ||
*Cryptococcus neoformans can be cultured from sputum or bronchoalveolar lavage or transbronchial lung biopsy specimen or pleural fluid or pleural biopsy specimen in patients with pulmonary cryptococcosis.<ref name="pmid2225944">{{cite journal| author=Chechani V, Kamholz SL| title=Pulmonary manifestations of disseminated cryptococcosis in patients with AIDS. | journal=Chest | year= 1990 | volume= 98 | issue= 5 | pages= 1060-6 | pmid=2225944 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2225944 }} </ref> | *Cryptococcus neoformans can be cultured from sputum or bronchoalveolar lavage or transbronchial lung biopsy specimen or pleural fluid or pleural biopsy specimen in patients with pulmonary cryptococcosis.<ref name="pmid2225944">{{cite journal| author=Chechani V, Kamholz SL| title=Pulmonary manifestations of disseminated cryptococcosis in patients with AIDS. | journal=Chest | year= 1990 | volume= 98 | issue= 5 | pages= 1060-6 | pmid=2225944 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2225944 }} </ref> | ||
===CSF Analysis=== | ===CSF Analysis=== | ||
Cryptococcal 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> | Cryptococcal 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> | ||
Revision as of 15:26, 6 June 2017
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Cryptococcosis Microchapters |
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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 |
Overview
Other diagnostic studies helpful for diagnosis of cryptococcal infection include demonstration of the budding yeast on India ink stain, staining the polysaccharide cell wall using Mucicarmine stain, detection of cryptococcal antigen in CSF and a positive culture for cryptococcus neoformans.
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.
- Cryptococcus neoformans can be cultured from sputum or bronchoalveolar lavage or transbronchial lung biopsy specimen or pleural fluid or pleural biopsy specimen in patients with pulmonary cryptococcosis.[1]
CSF Analysis
Cryptococcal meningitis may be differentiated from other causes of meningitis by cerebrospinal fluid examination as shown below:[2][3][4][5][6]
| Cerebrospinal fluid level | Normal level | Bacterial meningitis[5] | Viral meningitis[5] | Cryptococcal meningitis | Tuberculous meningitis[7] | Malignant meningitis[2] |
|---|---|---|---|---|---|---|
| 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)[3] | > 0.5 | < 0.3 | > 0.6 | <0.3 | < 0.5 | <0.5 |
| Lactate (mmols/l)[4] | < 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). [8]](/images/0/09/Cryptococcosis21.jpeg)
Cryptococcosis of lung in patient with AIDS. From Public Health Image Library (PHIL). [8] -
![Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). [8]](/images/7/70/Cryptococcosis20.jpeg)
Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). [8] -
![Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). [8]](/images/0/0c/Cryptococcosis19.jpeg)
Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). [8] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). [8]](/images/a/a3/Cryptococcosis18.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). [8] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [8]](/images/b/bd/Cryptococcosis17.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [8] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [8]](/images/5/56/Cryptococcosis16.jpeg)
Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [8] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using GMS stain. From Public Health Image Library (PHIL). [8]](/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). [8] -
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the lung using Mucicarmine stain. From Public Health Image Library (PHIL). [8]](/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). [8] -
![Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). [8]](/images/7/79/Cryptococcosis12.jpeg)
Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). [8] -
![Cryptococcus neoformans fungi from a liver specimen, and stained using the periodic acid-Schiff staining technique (980X mag). From Public Health Image Library (PHIL). [8]](/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). [8] -
![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). [8]](/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). [8] -
![Photomicrograph of a lung lesion tissue specimen, reveals some morphology associated with the disease cryptococcosis (800x mag). From Public Health Image Library (PHIL). [8]](/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). [8] -
![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). [8]](/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). [8]
![Cryptococcosis of lung in patient with AIDS. From Public Health Image Library (PHIL). [8]](/index.php/File:Cryptococcosis21.jpeg)
![Cryptococcosis of lung in patient with AIDS. Mucicarmine stain. From Public Health Image Library (PHIL). [8]](/index.php/File:Cryptococcosis20.jpeg)
![Cryptococcosis of lung in patient with AIDS. Methenamine silver stain. From Public Health Image Library (PHIL). [8]](/index.php/File:Cryptococcosis19.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of the spleen. From Public Health Image Library (PHIL). [8]](/index.php/File:Cryptococcosis18.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [8]](/index.php/File:Cryptococcosis17.jpeg)
![Micrograph depicts the histopathologic changes associated with cryptococcosis of an adrenal gland. From Public Health Image Library (PHIL). [8]](/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). [8]](/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). [8]](/index.php/File:Cryptococcosis14.jpeg)
![Micrograph depicts histopathologic changes due to cryptococcosis of the liver. From Public Health Image Library (PHIL). [8]](/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). [8]](/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). [8]](/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). [8]](/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). [8]](/index.php/File:Cryptococcosis03.jpeg)
References
- ↑ Chechani V, Kamholz SL (1990). "Pulmonary manifestations of disseminated cryptococcosis in patients with AIDS". Chest. 98 (5): 1060–6. PMID 2225944.
- ↑ 2.0 2.1 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.
- ↑ 3.0 3.1 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.
- ↑ 4.0 4.1 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.
- ↑ 5.0 5.1 5.2 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.
- ↑ 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 8.12 "Public Health Image Library (PHIL)".