BACKGROUND:
Central nervous system (CNS) histoplasmosis often goes unrecognized, delaying diagnosis and treatment, resulting in neurologic complications or death. It occurs in 5% to 10% of patients with disseminated histoplasmosis, and despite clinical suspicion of CNS involvement, laboratory confirmation can be challenging. Diagnosis is critically important, as these patients require longer courses and higher doses of liposomal amphotericin B than patients with disseminated disease not involving the CNS and longer monitoring after stopping treatment.
DISCUSSION:
A retrospective multicenter study was conducted with 50 cases and 157 controls to evaluate the sensitivity and specificity of a new anti-Histoplasma antibody enzyme immunoassay (EIA) for the detection of IgG and IgM antibody in the CSF for diagnosis of CNS histoplasmosis and to determine the effect of improvements in the Histoplasma galactomannan antigen detection EIA on the diagnosis of Histoplasma meningitis.