Azar Marwan M, Hage Chadi A
Department of Pathology, Section of Microbiology, Massachusetts General Hospital, Boston, Massachusetts, USA
Department of Medicine, Thoracic Transplantation Program, Indiana University, Indianapolis, Indiana, USA.
J Clin Microbiol. 2017 Jun;55(6):1612-1620. doi: 10.1128/JCM.02430-16. Epub 2017 Mar 8.
The diagnosis of histoplasmosis is based on a multifaceted approach that includes clinical, radiographic, and laboratory evidence of disease. The gold standards for laboratory diagnosis include demonstration of yeast on pathological examination of tissue and isolation of the mold in the culture of clinical specimens; however, antigen detection has provided a rapid, noninvasive, and highly sensitive method for diagnosis and is a useful marker of treatment response. Molecular methods with improved sensitivity on clinical specimens are being developed but are not yet ready for widespread clinical use. This review synthesizes currently available laboratory diagnostics for histoplasmosis, with an emphasis on complexities of testing and performance in various clinical contexts.
组织胞浆菌病的诊断基于多方面的方法,包括疾病的临床、影像学和实验室证据。实验室诊断的金标准包括在组织病理学检查中发现酵母以及在临床标本培养中分离出霉菌;然而,抗原检测提供了一种快速、非侵入性且高度敏感的诊断方法,并且是治疗反应的有用标志物。正在开发对临床标本敏感性更高的分子方法,但尚未准备好广泛应用于临床。本综述综合了目前可用的组织胞浆菌病实验室诊断方法,重点关注各种临床情况下检测的复杂性和性能。