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Utility of Measuring (13)--D-glucan for Patients With Fungal Infections

Nomura, Kenichi MD, PhD*†; Fujimoto, Yoshiko MD*; Yamashita, Mihoko MD*; Ohshiro, Muneo MD*; Kobayashi, Tsutomu MD*; Morimoto, Yasutaka MD†; Kanbayashi, Yuko Pharm D‡; Matsumoto, Yosuke MD, PhD*; Nakao, Mitsushige MD, PhD§; Kaneko, Hiroto MD, PhD∥; Shimazaki, Chihiro MD, PhD*; Taniwaki, Masafumi MD, PhD*¶

Infectious Diseases in Clinical Practice: January 2009 - Volume 17 - Issue 1 - pp 32-34
doi: 10.1097/IPC.0b013e318188db4f
Original Articles

To determine the use of measuring of (1→3)-β-D-glucan for diagnosis of systemic mycosis, we conducted a retrospective analysis. We investigated the clinical records of febrile patients whose blood samples were positive for Candida or Trichosporon or who were diagnosed with invasive aspergillosis based on autopsy. Five patients were diagnosed as infected with Candida species. Although 2 cases were initially diagnosed as negative because of a low level of (1→3)-β-D-glucan at the time of the first symptom, it became elevated after 2 or 3 days during the febrile episode, as it did in all 2 patients with infection of Trichosporon asahii. One patient was diagnosed with invasive aspergillosis. (1→3)-β-D-glucan remained below the cut-off value (20 pg/mL) throughout the febrile episode. Only 2 out of 8 patients had positive results at onset of fever, whereas 7 out of 8 patients had at least 1 positive result during episode. Measurement of (1→3)-β-D-glucan antigenemia produces a low ratio of pseudonegative cases for patients with systemic mycoses and is thus useful for the diagnosis of this fungal infection.

From the *Department of Hematology and Oncology, Kyoto Prefectural University of Medicine Graduate School of Medical Science; †Division of Microbiology, Kyoto Prefectural Institute of Public Health and Environment; ‡Department of Hospital Pharmacy Kyoto Prefectural University of Medicine, Kyoto; §Department of Internal Medicine, Otsu City Hospital, Otsu; ∥Department of Internal Medicine, Aiseikai Yamashina Hospital; and ¶Department of Molecular Cytogenetics and Laboratory Medicine, Kyoto and Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.

Reprints: Kenichi Nomura, MD, PhD, Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho Kawaramachi-Hirokoji Kamigyo-ku, Kyoto 602-0841, Japan. E-mail: nomuken@koto.kpu-m.ac.jp.

© 2009 Lippincott Williams & Wilkins, Inc.