Fungal Infections

Fungal diagnostics

  • Antigen detection
    • 1,3-β-D glucan (Se 77%, Sp 86%): Candida, Aspergillus, Histo, Coccidio, PCP. Cannot detect Mucor, Rhizopus, Blasto, Crypto. False ⊕ w/ IVIG, albumin, HD, gauze.
    • Galactomannan (Se 40%, but improved to 85% w/ BAL; Sp 89%) detects Aspergillus. Test serum if heme malig or HSCT. Do not use for screening or Rx monitoring in solid organ Tx, chronic granulomatous dis., or Rx/ppx for Asperg. (false ⊕ w/ colonization).
    • Histo urine/serum Ag: Se of urine Ag 90% (serum 80%) if dissem; Sp mited by X-react