<i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants
Two cases of cryptococcal meningitis went undetected by a cryptococcal antigen (CrAg) lateral flow assay on blood in a reflex CrAg screen-and-treat programme in South Africa, although <i>Cryptococcus neoformans</i> was identified by culturing the cerebrospinal fluid specimens. Further in...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2018-12-01
|
| Series: | Tropical Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2414-6366/4/1/1 |
| _version_ | 1811305510416154624 |
|---|---|
| author | Monica Birkhead Serisha D. Naicker Nozuko P. Blasich Ivy Rukasha Juno Thomas Charlotte Sriruttan Shareef Abrahams Grisselda S. Mavuso Nelesh P. Govender |
| author_facet | Monica Birkhead Serisha D. Naicker Nozuko P. Blasich Ivy Rukasha Juno Thomas Charlotte Sriruttan Shareef Abrahams Grisselda S. Mavuso Nelesh P. Govender |
| author_sort | Monica Birkhead |
| collection | DOAJ |
| description | Two cases of cryptococcal meningitis went undetected by a cryptococcal antigen (CrAg) lateral flow assay on blood in a reflex CrAg screen-and-treat programme in South Africa, although <i>Cryptococcus neoformans</i> was identified by culturing the cerebrospinal fluid specimens. Further investigations into these discordant diagnostic results included multilocus sequence typing (which showed no mutations in the CAP59 gene) and transmission electron microscopy using a capsule-staining protocol (which revealed a >50% reduction in capsular material in both cases, relative to a control culture). A multi-disciplinary approach for resolving discordant diagnostic test results is recommended. |
| first_indexed | 2024-04-13T08:27:43Z |
| format | Article |
| id | doaj.art-3570e8e2fd7b4b07973b3272894ddec3 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-04-13T08:27:43Z |
| publishDate | 2018-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-3570e8e2fd7b4b07973b3272894ddec32022-12-22T02:54:23ZengMDPI AGTropical Medicine and Infectious Disease2414-63662018-12-0141110.3390/tropicalmed4010001tropicalmed4010001<i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular VariantsMonica Birkhead0Serisha D. Naicker1Nozuko P. Blasich2Ivy Rukasha3Juno Thomas4Charlotte Sriruttan5Shareef Abrahams6Grisselda S. Mavuso7Nelesh P. Govender8National Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaNational Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaNational Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaNational Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaNational Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaNational Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaNational Health Laboratory Service, Port Elizabeth Provincial Hospital, Cnr Buckingham & Eastbourne Road, Port Elizabeth 6001, South AfricaNational Health Laboratory Service, Tambo Memorial Hospital, Cnr Hospital & Railway Street, Boksburg 1459, South AfricaNational Institute for Communicable Diseases—a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South AfricaTwo cases of cryptococcal meningitis went undetected by a cryptococcal antigen (CrAg) lateral flow assay on blood in a reflex CrAg screen-and-treat programme in South Africa, although <i>Cryptococcus neoformans</i> was identified by culturing the cerebrospinal fluid specimens. Further investigations into these discordant diagnostic results included multilocus sequence typing (which showed no mutations in the CAP59 gene) and transmission electron microscopy using a capsule-staining protocol (which revealed a >50% reduction in capsular material in both cases, relative to a control culture). A multi-disciplinary approach for resolving discordant diagnostic test results is recommended.https://www.mdpi.com/2414-6366/4/1/1<i>Cryptococcus neoformans</i>capsulelateral flow assaymolecular characterisationtransmission electron microscopy |
| spellingShingle | Monica Birkhead Serisha D. Naicker Nozuko P. Blasich Ivy Rukasha Juno Thomas Charlotte Sriruttan Shareef Abrahams Grisselda S. Mavuso Nelesh P. Govender <i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants Tropical Medicine and Infectious Disease <i>Cryptococcus neoformans</i> capsule lateral flow assay molecular characterisation transmission electron microscopy |
| title | <i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants |
| title_full | <i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants |
| title_fullStr | <i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants |
| title_full_unstemmed | <i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants |
| title_short | <i>Cryptococcus neoformans</i>: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants |
| title_sort | i cryptococcus neoformans i diagnostic dilemmas electron microscopy and capsular variants |
| topic | <i>Cryptococcus neoformans</i> capsule lateral flow assay molecular characterisation transmission electron microscopy |
| url | https://www.mdpi.com/2414-6366/4/1/1 |
| work_keys_str_mv | AT monicabirkhead icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT serishadnaicker icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT nozukopblasich icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT ivyrukasha icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT junothomas icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT charlottesriruttan icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT shareefabrahams icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT grisseldasmavuso icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants AT neleshpgovender icryptococcusneoformansidiagnosticdilemmaselectronmicroscopyandcapsularvariants |