Diagnosis of pulmonary histoplasmosis and blastomycosis by detection of antigen in bronchoalveolar lavage fluid using an improved second-generation enzyme-linked immunoassay

Respir Med. 2007 Jan;101(1):43-7. doi: 10.1016/j.rmed.2006.04.017. Epub 2006 Jun 6.

Abstract

Antigen 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.

Publication types

  • Case Reports
  • Comparative Study
  • Evaluation Study

MeSH terms

  • Antigens, Fungal / analysis*
  • Blastomycosis / diagnosis*
  • Bronchoalveolar Lavage Fluid / immunology*
  • Chi-Square Distribution
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Histoplasma / immunology
  • Histoplasmosis / diagnosis*
  • Humans
  • Immunocompromised Host
  • Liver Transplantation
  • Lung Diseases, Fungal / diagnosis*
  • Middle Aged
  • Statistics, Nonparametric

Substances

  • Antigens, Fungal