1. Diagnosis of pulmonary histoplasmosis and blastomycosis by detection of antigen in bronchoalveolar lavage fluid using an improved second-generation enzyme-linked immunoassay
- Author
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Michelle Durkin, Michelle Parker, Lindsey Egan, L. Joseph Wheat, Kenneth S. Knox, DeAnna Fuller, Deborah Blue-Hnidy, Ann M. LeMonte, Chadi A. Hage, Patricia Connelly, and Thomas E. Davis
- Subjects
Bronchoalveolar lavage ,Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Antigens, Fungal ,medicine.medical_treatment ,Histoplasma ,Enzyme-Linked Immunosorbent Assay ,Liver transplantation ,Statistics, Nonparametric ,Histoplasmosis ,Blastomycosis ,Second-generation assay ,Immunocompromised Host ,Antigen ,Humans ,Medicine ,Mycosis ,Chi-Square Distribution ,Lung Diseases, Fungal ,medicine.diagnostic_test ,biology ,business.industry ,Respiratory disease ,Middle Aged ,medicine.disease ,biology.organism_classification ,Liver Transplantation ,Histoplasma antigen ,Immunology ,Female ,business ,Bronchoalveolar Lavage Fluid - Abstract
SummaryAntigen detection is a useful adjunct for the diagnosis of histoplasmosis. The purpose of this study was to evaluate antigen detection in bronchoalveolar lavage (BAL) fluid using an improved second-generation Histoplasma antigen assay. Antigen was detected in 16 of 19 (84%) cases of histoplasmosis and 5 of 6 (83.3%) blastomycosis cases using the second-generation assay vs. 13 of 19 (68%) and 4 of 6 (66.7%), respectively, in the original assay. Ten-fold concentration permitted detection of antigen in an additional case of histoplasmosis and another with blastomycosis, for an overall sensitivity of 23 of 25 (92.0%). Specificity was 98.2% in both assays in controls with other pulmonary infections. These findings support the diagnostic utility of the second-generation assay in patients with pulmonary histoplasmosis and blastomycosis.
- Published
- 2007
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