False-positive cerebrospinal fluid cryptococcus antigen in Libman-Sacks endocarditis.

Background: Cryptococcus meningoencephalitis is a serious opportunistic infection associated with high morbidity and mortality in immunocompromised hosts, particularly patients with advanced AIDS disease. The diagnosis is established through cerebrospinal fluid (CSF) cryptococcus antigen detection a...

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Detalles Bibliográficos
Publicado en:Infection Vol. 44; no. 6; pp. 803 - 806
Autores principales: Isseh, Iyad, Bourgi, Kassem, Nakhle, Asaad, Ali, Mahmoud, Zervos, Marcus
Formato: case study Journal Article
Publicado: Springer Nature Dec2016
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Background: Cryptococcus meningoencephalitis is a serious opportunistic infection associated with high morbidity and mortality in immunocompromised hosts, particularly patients with advanced AIDS disease. The diagnosis is established through cerebrospinal fluid (CSF) cryptococcus antigen detection and cultures. Cryptococcus antigen testing is usually the initial test of choice due its high sensitivity and specificity along with the quick availability of the results. Case report: We hereby report a case of a false-positive CSF cryptococcus antigen assay in a patient with systemic lupus erythematosus presenting with acute confusion. While initial CSF evaluation revealed a positive cryptococcus antigen assay, the patient's symptoms were inconsistent with cryptococcus meningoencephalitis. A repeat CSF evaluation, done 3 days later, revealed a negative CSF cryptococcus antigen assay. Conclusion: Given the patient's active lupus disease and the elevated antinuclear antibody titers, we believe that the initial positive result was a false positive caused by interference from autoantibodies.