SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Cryptococcal Antigen in Serum and Cerebrospinal Fluid for Detecting Cryptococcal Meningitis in Adults Living With Human Immunodeficiency Virus: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A clinical practice guideline for tuberculous meningitis.The Lancet. Infectious diseases · 2026Guideline
- Diagnostic performance of the IMMY cryptococcal antigen lateral flow assay on serum and cerebrospinal fluid for diagnosis of cryptococcosis in HIV-negative patients: a systematic review.BMC infectious diseases · 2023Pooled it
- Efficacy of induction regimens for cryptococcal meningitis in HIV-infected adults: a systematic review and network meta-analysis.Scientific reports · 2021Pooled it
- The future of fungal diagnostics: What's next in laboratory testing for invasive fungal infection?Medical mycology · 2026Review
- Clinical Significance of Serum (1→3)-β-D-Glucan Positivity in Cryptococcosis: A Retrospective Cohort Study.Journal of fungi (Basel, Switzerland) · 2026Article
- The Dynamiker cryptococcal antigen lateral flow assay is an accurate, rapid and cost effective test comparable to culture for detection of cryptococcal meningitis.Journal of medical microbiology · 2026Article
- Disseminated Cryptococcosis in a Non-HIV Patient: Diagnostic Value of Integrating mNGS, Culture, and Antigen Testing.Infection and drug resistance · 2026Article
- Individualized immunotherapy for immune reconstitution-associated cortical encephalitis in an HIV-positive cryptococcal meningitis patient: a case report.Frontiers in immunology · 2026Article
- The Diagnostic Challenge of a False-Positive Cryptococcal Antigen in Chronic Meningitis with Suspected Indolent CNS B-Cell Lymphoproliferative Neoplasm.Journal of fungi (Basel, Switzerland) · 2025Article
- Disparities in Fungal Diagnostic Capacity Across Chinese Hospitals: A Nationwide Survey Highlighting Gaps in Molecular Testing and GDP-Linked Inequalities.Mycopathologia · 2025Article
- Cryptococcosis in Pediatric Renal Transplant Recipients: Comparative Insights from Adult Cases.Medicina (Kaunas, Lithuania) · 2025Review
- Role of liposomal amphotericin B in intensive care unit: an expert opinion paper.Journal of anesthesia, analgesia and critical care · 2025Review
- Early diagnosis of cryptococcal meningoencephalitis in HIV-negative patients: Integration of brain MRI and clinical findings.eNeurologicalSci · 2025Article
- A Prospective Evaluation of the Diagnostic Accuracy of the Point-of-Care VISITECT CD4 Advanced Disease Test in 7 Countries.The Journal of infectious diseases · 2025Article
- An Atypical Presentation of Culture-Negative Cryptococcal Meningitis in an Immunocompetent Host With Prior Stroke: A Case Report.Case reports in infectious diseases · 2025Article
- Metagenomic next-generation sequencing for cryptococcal meningitis diagnosis: a single-center experience.Frontiers in cellular and infection microbiology · 2025Article
- CsDETC: detection and counting of small targetFrontiers in cellular and infection microbiology · 2025Article
- Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections.Clinical microbiology reviews · 2024Review
- Clinical treatment of cryptococcal meningitis: an evidence-based review on the emerging clinical data.Journal of neurology · 2024Review
- Central nervous system infections in the tropics.Current opinion in infectious diseases · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Cryptococcal antigen (CrAg) detection could direct the timely initiation of antifungal therapy. We searched MEDLINE and Embase for studies where CrAg detection in serum/cerebrospinal fluid (CSF) and CSF fungal culture were done on adults living with human immunodeficiency virus (HIV) who had suspected cryptococcal meningitis (CM). With Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), we evaluated the risk of bias in 11 included studies with 3600 participants, and used a random-effects meta-analysis to obtain summary sensitivity and specificity of serum and CSF CrAg, as well as agreement between CSF CrAg and CSF culture. Summary sensitivity and specificity of serum CrAg were 99.7% (97.4-100) and 94.1% (88.3-98.1), respectively, and summary sensitivity and specificity of CSF CrAg were 98.8% (96.2-99.6) and 99.3% (96.7-99.9), respectively. Agreement between CSF CrAg and CSF culture was 98% (97-99). In adults living with HIV who have CM symptoms, serum CrAg negativity may rule out CM, while positivity should prompt induction antifungal therapy if lumbar puncture is not feasible. In a first episode of CM, CSF CrAg positivity is diagnostic.
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