Ito Shoko, Ashizawa Masahiro, Sasaki Ryo, Ikeda Takashi, Toda Yumiko, Mashima Kiyomi, Umino Kento, Minakata Daisuke, Nakano Hirofumi, Yamasaki Ryoko, Kawasaki Yasufumi, Sugimoto Miyuki, Yamamoto Chihiro, Fujiwara Shin-Ichiro, Hatano Kaoru, Sato Kazuya, Oh Iekuni, Ohmine Ken, Muroi Kazuo, Suzuki Jun, Hatakeyama Shuji, Morisawa Yuji, Yamada Toshiyuki, Kanda Yoshinobu
Division of Hematology, Department of Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
J Infect Chemother. 2018 Oct;24(10):812-814. doi: 10.1016/j.jiac.2018.06.008. Epub 2018 Jul 11.
The 1,3-beta-D-Glucan (BDG) assay is widely used for the diagnosis of fungal infections, especially in patients with hematologic malignancies. Some antimicrobials have been reported to cause false-positive results for BDG, but there has been no report on the effect of penicillin G (PCG) on BDG levels. We experienced a patient who developed false-positive BDG elevation during the administration of PCG for osteomyelitis due to Streptococcus pneumoniae infection. The serum BDG level increased up to 81.0 pg/ml during the continuous administration of PCG at 24 million units per day. However, chest and paranasal CT scan showed no evidence of fungal infection. The BDG level decreased to 38.0 pg/ml at 14 hours after the discontinuation of PCG. The amount of BDG in one vial of PCG inferred from these serum BDG levels is very similar to the actual BDG concentration in a vial of PCG. Therefore, during the administration of PCG, elevated BDG levels should be interpreted with caution, as they may be false-positive results.
1,3-β-D-葡聚糖（BDG）检测广泛用于真菌感染的诊断，尤其是血液系统恶性肿瘤患者。据报道，一些抗菌药物会导致BDG检测出现假阳性结果，但关于青霉素G（PCG）对BDG水平影响的报道尚未见。我们遇到一名因肺炎链球菌感染导致骨髓炎而在使用PCG治疗期间出现BDG假阳性升高的患者。在每天持续使用2400万单位PCG期间，血清BDG水平升至81.0 pg/ml。然而，胸部和鼻窦CT扫描未显示真菌感染迹象。停用PCG后14小时，BDG水平降至38.0 pg/ml。根据这些血清BDG水平推断，一瓶PCG中的BDG量与一瓶PCG中的实际BDG浓度非常相似。因此，在使用PCG期间，BDG水平升高应谨慎解读，因为它们可能是假阳性结果。
