ArticleOpen forum infectious diseases2014
Detection of High Cerebrospinal Fluid Levels of (1→3)-β-d-Glucan in Cryptococcal Meningitis.
Article in Open forum infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- (1→3)-β-D-glucan testing for the detection of invasive fungal infections in immunocompromised or critically ill people.The Cochrane database of systematic reviews · 2020Pooled it
- Efficacy of Cerebrospinal Fluid Beta-d-Glucan Diagnostic Testing for Fungal Meningitis: a Systematic Review.Journal of clinical microbiology · 2020Pooled it
- Comparison of PBS-Caffeine and Caffeine Buffers for Inhibiting Exocytosis During Horseshoe Crab Blood Collection and Improving the Yield of Limulus Amebocyte Lysate (LAL) for Endotoxin Detection.International journal of molecular sciences · 2026Article
- Clinical Significance of Serum (1→3)-β-D-Glucan Positivity in Cryptococcosis: A Retrospective Cohort Study.Journal of fungi (Basel, Switzerland) · 2026Article
- Article
- Reframing the clinical phenotype and management of cryptococcal meningitis.Practical neurology · 2025Review
- Purulent pericarditis caused byFrontiers in cardiovascular medicine · 2025Article
- Persistent fever after coronavirus disease 2019 in liver/kidney transplant recipient.Transplant infectious disease : an official journal of the Transplantation Society · 2024Article
- A Retrospective Analysis of Central and Peripheral Metabolic Characteristics in Patients with Cryptococcal Meningitis.Neurology and therapy · 2024Article
- Diagnosis and management of cryptococcal meningitis in HIV-infected adults.Clinical microbiology reviews · 2023Review
- The Cryptococcus wall: A different wall for a unique lifestyle.PLoS pathogens · 2023Article
- Noninvasive Testing and Surrogate Markers in Invasive Fungal Diseases.Open forum infectious diseases · 2022Article
- Beta-D-Glucan in Patients with Haematological Malignancies.Journal of fungi (Basel, Switzerland) · 2021Review
- Challenges with Utilizing the 1,3-Beta-d-Glucan and Galactomannan Assays To Diagnose Invasive Mold Infections in Immunocompromised Children.Journal of clinical microbiology · 2021Article
- Unexpected case of cryptococcal meningoencephalitis in a patient with long-standing well-controlled HIV infection.Medical mycology case reports · 2021Article
- Efficacy and Pharmacokinetics of Fosmanogepix (APX001) in the Treatment ofAntimicrobial agents and chemotherapy · 2021Article
- Single and Repeated Episodes ofFrontiers in microbiology · 2021Article
- Methods for rapid diagnosis of meningitis etiology in adults.Biomarkers in medicine · 2020Review
- New Insights Into Cryptococcus Spp. Biology and Cryptococcal Meningitis.Current neurology and neuroscience reports · 2019Review
- Diagnosis and Management of Central Nervous System Cryptococcal Infections in HIV-Infected Adults.Journal of fungi (Basel, Switzerland) · 2019Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 4 countries.
Funding
Abstract
background(1→3)-β-d-Glucan (BDG) is a helpful diagnostic marker for many invasive fungal infections. However, BDG is not thought to be useful in diagnosing cryptococcosis. We evaluated the utility of BDG as an adjunct diagnostic tool for patients infected with human immunodeficiency virus (HIV) and presenting with suspected cryptococcal meningitis.
methodsThe Fungitell assay was used to measure BDG concentrations in cerebrospinal fluid (CSF) (n = 177) and serum (n = 109) of HIV-infected Ugandans and South Africans with suspected meningitis. Correlations between BDG concentrations and quantitative CSF cryptococcal cultures, CSF cryptococcal antigen (CRAG) titers, and 18 different CSF cytokine concentrations were assessed using non-parametric tests. Mixed models evaluated longitudinal changes in CSF BDG concentrations. Survival analyses were used to evaluate BDG's relationship with mortality.
resultsThe Fungitell BDG assay provided 89% sensitivity and 85% specificity in CSF for cryptococcal meningitis. Serum sensitivity was suboptimal (79%). Cerebrospinal fluid BDG concentrations at diagnosis were median (interquartile range) 343 (200-597) pg/mL in cryptococcal patients and 37 (23-46) pg/mL in patients without cryptococcosis. Sensitivity in CSF improved to 98% (53 of 54) when initial fungal burdens were ≥10 000 colony-forming units/mL. (1→3)-β-d-Glucan normalized rapidly after initiating antifungal therapy. Baseline BDG concentrations correlated with CSF fungal burden (rho = 0.820; P < .001), CSF CRAG lateral flow assay titers (rho = 0.780, P < .001), and monocyte chemotactic protein-1 levels in CSF (P = .047). In patients with cryptococcal meningitis, BDG ≥500 pg/mL at diagnosis was associated with increased 10-week mortality.
conclusions(1→3)-β-d-Glucan is detectable in the CSF of HIV-infected patients with Cryptococcus, and it may provide useful prognostic information. Sensitivity is less than CRAG; however, BDG normalizes rapidly, unlike CRAG, making BDG potentially useful in diagnosing recurrent episodes.
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