Villareal Kenneth, Price Austin, Pasqualotto Alessandro C, Bahr Nathan C
Division of Infectious Diseases, Department of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Department of Clinical Medicine and Post-Graduation Program in Pathology, Universidade Federal de Ciências da Saúde, Porto Alegre 90050-170, Brazil.
J Fungi (Basel). 2023 Jul 28;9(8):793. doi: 10.3390/jof9080793.
Histoplasmosis is caused by and, although endemic in large parts of the world, is often underrecognized in many locations. In addition to underrecognition, inadequate availability of diagnostic tests is a major contributor to poor outcomes in disseminated disease in people with HIV. For those with advanced HIV and disseminated disease, antibody testing is less useful. Culture and histopathology can be useful in this situation, but each has limitations, including variable sensitivity by site and, in the case of culture, the need for a biosafety level three laboratory and a long period of growth. Antigen testing has proven useful for disseminated histoplasmosis due to the excellent sensitivity of urine. Yet, turnaround is slower than ideal due to use in a limited number of centers. The development of lateral flow assays has the potential to make for true rapid point-of-care assays for histoplasmosis, but in order to meet that promise, the tests must be widely available and affordable.
组织胞浆菌病由[具体病原体未给出]引起，尽管在世界大部分地区呈地方性流行，但在许多地方往往未得到充分认识。除了认识不足外，诊断检测手段的可及性不足也是导致艾滋病患者播散性疾病预后不良的主要因素。对于晚期艾滋病和播散性疾病患者，抗体检测的作用较小。培养和组织病理学检查在这种情况下可能有用，但每种方法都有局限性，包括不同部位的敏感性差异，就培养而言，需要生物安全三级实验室且培养时间较长。由于尿液检测具有出色的敏感性，抗原检测已被证明对播散性组织胞浆菌病有用。然而，由于仅在少数中心使用，检测周转时间比理想情况要长。侧流分析检测方法的开发有可能实现真正快速的组织胞浆菌病即时检测，但为了实现这一前景，这些检测必须广泛可得且价格可承受。
