OBJECTIVE: To evaluate the value of cryptococcal latex agglutination test in the diagnosis and treatment of cryptococcal meningitis in children. METHODS: The clinical data of 10 children with cryptococcal meningitis were retrospectively studied. Cryptococcal meningitis was confirmed based on clinical manifestations, India ink stain, cryptococcal latex agglutination test or cryptococcal culture. The outcome of antifungal treatment and the changes of latex agglutination test titer were followed up for 2 to 4 years. RESULTS: Latex agglutination test and/or India ink stain were positive (titer 1 : 64-1 : 1024) in 8 patients in the first examination of cerebrospinal fluid. In the other 2 patients, latex agglutination test was positive (titer 1 : 256) in the fourth examination of cerebrospinal fluid in one, and India ink stain was positive in the eleventh examination in the other. After antifungal treatment, six patients were cured, two patients died, and two patients were lost to follow-up. The positive cryptococcal latex agglutination test (titer 1 : 2-1 : 16) was seen respectively in six, three, two and one cured patients 6 months, 1 year, 2 years and 4 years later. CONCLUSIONS: The cryptococcal latex agglutination test of cerebrospinal fluid is valuable for the quick and early diagnosis of cryptococcal meningitis; however, the decision of withdrawal of antifungal treatment should not rely on the results of the test.
Key words
Latex agglutination test /
Cryptococcal meningitis /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
［1］Saha DC, Xess I, Jain N. Evaluation of conventional ﹠serological methods for rapid diagnosis of cryptococcosis［J］. Indian J Med Res, 2008, 127(5):483-488.
［2］Lin TY, Yeh KM, Lin JC, Wang NC, Peng MY, Chang FY. Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers［J］. J Microbiol Immunol Infect, 2009, 42(3): 220-226.
［3］McCarthy KM, Morgan J, Wannermuehler KA, Mirza SA, Gould AM, Mhlongo N, et al. Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence［J］. AIDS, 2006, 20(17): 2199-2206.
［4］牟向东，李若瑜，万喆，王广，柳平，王仁贵，等. 血清乳胶凝集试验诊断肺隐球菌病的临床对照研究［J］. 中华结核和呼吸杂志, 2008, 31(5): 360-363.
［5］李京红, 张国俊. 新型隐球菌脑膜炎脑脊液的检测方法探讨［J］. 中国实用神经疾病杂志, 2009, 12(15): 85-87.
［6］胡亚美，江载芳. 诸福棠实用儿科学［M］.第7版.北京：人民卫生出版社，2002:10541056.
［7］葛朝莉，白润涛，韩漫夫. 影响隐球菌性脑膜炎确诊的因素分析［J］. 疑难病杂志, 2005, 4(2): 74-76.
［8］江磊，张伦理. 新型隐球菌脑膜炎38例［J］. 中华传染病杂志, 2007, 25(4): 203-205.
［9］李雯，林洁. 脑脊液玻片离心染色法在新型隐球菌检测中的应用［J］. 中国人兽共患病杂志, 2004, 20(12): 1100.
［10］郭爱华. 隐球菌性脑膜炎的诊断与治疗进展［J］. 中国实用内科杂志, 2005, 25(5): 478.
［11］王鑫，刘瑞春，何俊英，何红彦，张静，时东彦. 隐球菌性脑膜炎患者抗原及抗体检测的临床评价［J］. 脑与神经疾病杂志, 2008, 16(4): 409-411.
［12］旷寿金，殷萍，黑明燕，易靖. 儿童新型隐球菌脑膜炎治疗体会（附４例报告）［J］.中国现代医学杂志, 2003, 13(9): 147-148.
［13］王露霞，石凌波， 陈万山，肖增璜，成德. 乳胶凝集法检测隐球菌荚膜多糖抗原在隐球菌性脑膜炎和隐球菌肺炎中的早期诊断价值［J］. 检验医学, 2008, 23(1): 55-57.
［14］朱元杰， 张俊勇， 顾菊林，陈江汉，徐红，赵瑾,等. 非爱滋病患者隐球菌脑膜炎治疗与随访过程中真菌学指标分析［J］. 中华传染病杂志, 2009, 27(9): 540-542.
［15］卢洪洲，曹天高，周颖杰，尹有宽， 潘孝彰，翁心华. 乳胶凝集试验对新型隐球菌性脑膜炎诊断及治疗的意义［J］. 中华传染病杂志, 2005, 23(3): 209-211.
［16］王露霞，刘海英，石凌波，邓婉梨，林碎玲，李志斌, 等. 隐球菌荚膜多糖抗原乳胶凝集试验干扰因素的探讨［J］. 临床检验杂志, 2010, 28(2): 159.
PDF(1020 KB)
