Recommendations for evaluation of suspected Histoplasma meningitis^[1]

Recommendations for evaluation of suspected Histoplasma meningitis^[1]

Source		Test
Source		Fungal culture	Histoplasma antigen test	Anti-Histoplasma antibody*	Histopathologic examination for fungi
Initial evaluation in all patients	Cerebrospinal fluid^¶	X	X	X
	Blood	X	X	X
	Urine		X
	Biopsy of non-CNS site (eg, bone marrow) if evidence of involvement	X			X
Additional testing if initial evaluation is negative	Cisternal or ventricular fluid^Δ	X	X	X
Additional testing if initial evaluation is negative	Biopsy of brain or meninges	X			X

CNS: central nervous system.
* Testing by complement fixation and immunodiffusion, beginning with undiluted cerebrospinal fluid.
¶ For best results, a 10 to 20 mL sample should be obtained. However, a negative culture does not exclude the diagnosis.
Δ Additional test for cisternal or ventricular fluid includes microscopic examination for fungi.

Reference:

Wheat LJ, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis 2007; 45:807.

Adapted from: Wheat LJ, Musial CE, Jenny-Avital E. Diagnosis and management of central nervous system histoplasmosis. Clin Infect Dis 2005; 40:844.

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خرید پکیج

Recommendations for evaluation of suspected Histoplasma meningitis[1]

Recommendations for evaluation of suspected Histoplasma meningitis^[1]