Ringer Matthew, Radcliffe Christopher, Kerantzas Christopher A, Malinis Maricar, Azar Marwan M
Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Department of Laboratory Medicine, Yale University School of Medicine New Haven, CT, USA.
IDCases. 2021 Oct 27;26:e01322. doi: 10.1016/j.idcr.2021.e01322. eCollection 2021.
Beta-D-glucan (BDG) testing can expedite the diagnosis of invasive fungal infections in immunocompromised hosts. Elevated BDG levels have been reported in both studies assessing cross-reactivity with spp. and published cases of patients with nocardiosis, but there is little data on this association in solid organ transplantation (SOT) recipients. To explore this association, we conducted a case series of SOT recipients with culture-proven nocardiosis and BDG testing who received their care at our institution between 2016 and 2021. We found thirteen cases of nocardiosis in SOT recipients, of which three cases met our case definition of an elevated BDG. Their clinical courses are detailed in the present report. We found that BDG may be elevated in SOT with nocardiosis with no identified cause of false positive BDG, though a causal association cannot be determined. Future prospective studies that better evaluate the association between nocardiosis and BDG are warranted, as are studies that better characterize the possible variability in reactivity amongst spp.
β-D-葡聚糖（BDG）检测可加快免疫功能低下宿主侵袭性真菌感染的诊断。在评估与诺卡菌属交叉反应性的研究以及已发表的诺卡菌病患者病例中均报告了BDG水平升高，但关于实体器官移植（SOT）受者中这种关联的数据很少。为了探究这种关联，我们对2016年至2021年期间在我们机构接受治疗、经培养证实患有诺卡菌病并进行了BDG检测的SOT受者进行了病例系列研究。我们在SOT受者中发现了13例诺卡菌病病例，其中3例符合我们关于BDG升高的病例定义。本报告详细介绍了他们的临床病程。我们发现，在未发现BDG假阳性原因的情况下，SOT合并诺卡菌病时BDG可能升高，不过无法确定因果关系。有必要开展未来前瞻性研究，以更好地评估诺卡菌病与BDG之间的关联，同样也需要开展研究来更好地描述诺卡菌属之间反应性可能存在的变异性。
