False-negative Histoplasma antigen in acute pulmonary histoplasmosis: the value of urinary concentration by ultrafiltration and heat denaturation of serum proteins in detection of Histoplasma antigen.
We report an infant with localized pulmonary histoplasmosis in whom Histoplasma antibody assays, quantitative Histoplasma urine and serum antigen concentrations, and histopathologic findings of a mediastinal mass were nondiagnostic. A provisional diagnosis of histoplasmosis was established by using laboratory methods that increase the sensitivity of the antigen assay using ultrafiltration of urine and ethylenediaminetetraacetic acid/heat denaturation of serum proteins.
Srinivasan
Ashok
A
Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA. ashok.srinivasan@stjude.org
Kleiman
Martin B
MB
Debelenko
Larisa
L
Stokes
Dennis C
DC
De Vincenzo
John
J
Wheat
Joseph L
JL
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000302:isolation & purification* / Q000652:urine; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006358:Hot Temperature; D006801:Humans; D007223:Infant; D017964:Itraconazole / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D011489:Protein Denaturation; D012680:Sensitivity and Specificity; D014462:Ultrafiltration / Q000379:methods
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D000946:Antigens, Fungal; D017964:Itraconazole; D011241:Prednisone