[Usefulness of (1-->3)-beta-D-glucan measurement for diagnosis of deep mycosis].
The number of deep mycosis has been increasing because of increases in immunocompromised hosts and in fungal colonization associated with increasing use of broad-spectrum antibacterial antibiotics. Based on these phenomenon, a simple test method for an early diagnosis of deep mycosis is urgently desired. We therefore investigated the usefulness of assaying a fungal cell component, (1-->3)-beta-D-glucan (beta-glucan). The amount of beta-glucan was obtained from the difference between the amounts determined using Toxicolor and Endospecy, and the serum levels of more than 10 pg/ml were considered positive signs for beta-glucan. The following results were obtained: We found that beta-glucan was positive in 75% of the patients who had been definitely diagnosed to have mycosis, and in 58.3% of the patients strongly suspected of mycosis. The numbers of beta-glucan positive patients' in these 2 groups of patients were significantly different from that in those without mycosis (14.7%, P < 0.05). Thus a usefulness of beta-glucan measurement for the diagnosis of mycosis was demonstrated. However, beta-glucan was sometimes negative even in patients with fungemia at an early phase of the disease and turned positive several days later. Even in a patient with definite lung mycosis, who had a latent circumscribed lesion (afebrile and CRP-negative), beta-glucan was also negative. From these findings, one should be aware that the beta-glucan test produces false negatives even in patients with definite mycosis and that the test should be repeated during the course of the disease.
Furuya
T
T
First Department of Internal Medicine, Tokyo Medical College.
Toyama
K
K
D000368:Aged; D005260:Female; D005936:Glucans / Q000097:blood*; D006402:Hematologic Diseases / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D008033:Limulus Test / Q000379:methods; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000209:etiology; D047071:beta-Glucans
D005936:Glucans; D047071:beta-Glucans; C033363:beta-1,3-glucan