[The Clinical Significance of Plasma]
(1 --> 3)- beta - D -Glucan ( beta -glucan), a fungal cell wall component existing in plasma was measured by the kinetic turbidimetric limulus test. Here 3 reported cases have proven the clinical usefulness of plasma beta -glucan. Case 1: A 46-year-old female with non-Hodgkin's lymphoma was admitted for severe hepatitis type B in June 1997. During hospitalization, the fever rose with no response to antibiotics and with a negative blood culture. Although the plasma beta -glucan concentration was high, the patient was administered with antimycotics (fluconazole; FLCZ) and she showed some signs of improvement. Case 2: A 52-year-old male with jaundice was hospitalized in November 1997. The third day following the operation on the pancreas head carcinoma, the body temperature rose higher with a negative blood culture. The fourth day, the plasma beta -glucan concentration was positive with negative endotoxin. As some improvements were obserbed from taking FLCZ, he was discharged in January 1998. Case 3: A 19-year-old male with epilepsy was hospitalized for ARDS in August 1997. A butterfly-like shadow was observed in the chest roentgenogram (suspected malignant lymphoma). The high titer of beta -glucan has continued and endotoxin was detected. The symptoms showed some signs of improvement and the titer of beta -glucan reduced with FLCZ. Although a high level of beta -glucan still remained, the patient was discharged, but has to under go regular follow-up examinations. The measurment of beta -glucan proved very useful not only as a diagnosis for the screening of deep mycosis but also as monitoring for therapies.
Department of Clinical Pathology, Showa University Fujigaoka Hospital, Yokohama 227-0043, Japan.
Y
Nakamura
S
Tazawa
M
Tsutiya