曲霉性脑膜炎：基于非培养的微生物学方法诊断与管理
Aspergillus meningitis: diagnosis by non-culture-based microbiological methods and management.
作者信息
Verweij P E, Brinkman K, Kremer H P, Kullberg B J, Meis J F
机构信息
Departments of Medical Microbiology, University Hospital Nijmegen, Nijmegen, The Netherlands.
出版信息
J Clin Microbiol. 1999 Apr;37(4):1186-9. doi: 10.1128/JCM.37.4.1186-1189.1999.
Abstract
The performance of antibody detection, antigen detection, and Aspergillus genus-specific PCR for diagnosing Aspergillus meningitis was investigated with 26 cerebrospinal fluid (CSF) samples obtained from a single patient with proven infection caused by Aspergillus fumigatus. Immunoglobulin G antibodies directed against Aspergillus were not detected by enzyme-linked immunosorbent assay in CSF or serum. The antigen galactomannan was detected in the CSF 45 days before a culture became positive, and Aspergillus DNA was detected 4 days prior to culture. Decline of the galactomannan antigen titer in the CSF during treatment with intravenous and intraventricular amphotericin B and intravenous voriconazole corresponded with the clinical response to treatment.
摘要
利用从一名确诊为烟曲霉感染的患者身上获取的26份脑脊液（CSF）样本，对抗体检测、抗原检测和曲霉属特异性PCR在诊断曲霉性脑膜炎方面的性能进行了研究。通过酶联免疫吸附测定法未在脑脊液或血清中检测到针对曲霉的免疫球蛋白G抗体。在培养结果呈阳性前45天，在脑脊液中检测到了半乳甘露聚糖抗原，在培养前4天检测到了曲霉DNA。在静脉内和脑室内使用两性霉素B以及静脉内使用伏立康唑治疗期间，脑脊液中半乳甘露聚糖抗原滴度的下降与治疗的临床反应相符。
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