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Cited by 172Fungal Infections and StudiesHistiocytic Disorders and TreatmentsAntifungal resistance and susceptibility

Improvements in diagnosis of histoplasmosis.

Wheat, L Joseph·2006·Expert Opinion on Biological Therapy
DOI 10.1517/14712598.6.11.1207
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Abstract

Understanding the uses and limitations of a battery of laboratory methods is essential to diagnose histoplasmosis. Antigen detection and serology are valuable adjuncts to histopathology and culture. Improvements incorporated into the second-generation Histoplasma antigen assay have increased its sensitivity and specificity for diagnosis of histoplasmosis. More recently, the antigen assay has been modified to provide quantitation, which improves reproducibility and facilitates monitoring antigen clearance during treatment. Furthermore, detection of antigen in bronchoalveolar lavage fluid increases the sensitivity for diagnosis of pulmonary histoplasmosis. Serological tests for antibodies are also useful, but may be falsely negative in immunosuppressed patients. In addition, elevated antibody titres persist for several years following initial infection, complicating their interpretation. Although histopathology may provide for rapid diagnosis, its sensitivity is < 50% in patients with disseminated disease and even lower in pulmonary histoplasmosis. Polymerase chain reaction has been described, but sensitivity is less than that of histopathology. Culture, although highly specific, has notable limitations, including insensitivity, a need for invasive procedures and delayed growth. This review provides the background for understanding the role of a battery of diagnostic methods in histoplasmosis. Tests facilitating a rapid diagnosis are expected to improve the outcome in patients with severe disease.

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  • Complications of disseminated histoplasmosis, including adrenal insufficiency, endovascular infection, meningitis, and hemophagocytic lymph histiocytosis, are uncommon but challenging to manage.

    “Complications of disseminated histoplasmosis, including adrenal insufficiency, endovascular infection, meningitis, and hemophagocytic lymph histiocytosis, are uncommon but challenging to manage [169].”

    From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [169]

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Authors
Wheat, L. J.
Corresponding author
Wheat, L Joseph
ORCID
Wheat, L Joseph
Venue
Expert Opinion on Biological Therapy
Publisher
Informa UK Limited
Published
2006-10-18
Volume
6
Issue
11
Pages
1207-1221
ISSN
  • 1471-2598 (ISSN-L)
  • 1744-7682
DOI
10.1517/14712598.6.11.1207
OpenAlex
W2160926511
Cited by
172
References
94
Citations by year
2026: 1 · 2025: 6 · 2024: 4 · 2023: 10 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 8 · 2018: 9 · 2017: 10 · 2016: 4 · 2015: 8 · 2014: 9 · 2013: 11 · 2012: 16
FWCI
1.41
Type
journal article
Language
en
Open access
closed
Locations
  • Expert Opinion on Biological Therapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
  • Health Sciences › Medicine › Physiology › Histiocytic Disorders and Treatments
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Keywords
histoplasmosis, serology, bronchoalveolar lavage, histopathology, culture, PCR, pulmonary histoplasmosis, disseminated histoplasmosis, immunosuppression, sensitivity and specificity, antigen quantitation, antibody persistence
MeSH terms
Animals, Antigens, Fungal, Histoplasmosis, Humans

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