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SCRYR<br />

28071<br />

CCRYR<br />

infections frequently involve the central nervous system (CNS), particularly in patients infected with HIV.<br />

Mortality in CNS cryptococcosis may approach 25% despite antibiotic therapy. Untreated CNS<br />

cryptococcosis is invariably fatal. Disseminated disease may affect any organ system and usually occurs<br />

in immunosuppressed individuals.<br />

Useful For: Aiding in the diagnosis of pulmonary cryptococcosis<br />

Interpretation: The presence of cryptococcal antigen in any body fluid is indicative of cryptococcosis.<br />

Higher titers appear to correlate with more severe infections. Declining titers in serum may indicate<br />

regression of infection or response to therapy. However, monitoring titers to cryptococcal antigen should<br />

not be used as a test of cure, as low level titers may persist for extended periods of time following<br />

appropriate therapy and the resolution of infection. In addition to testing for cryptococcal antigen, patients<br />

with presumed pulmonary disease due to Cryptococcus neoformans should have respiratory specimens<br />

(eg, bronchoalveolar lavage fluid) submitted for routine smear and fungal culture.<br />

Reference Values:<br />

Negative<br />

Clinical References: Hazen KC, Howell,SA: Candida, Cryptococcus, and other Yeasts of <strong>Medical</strong><br />

Importance. In Manual of Clinical Microbiology. 9th edition. Edited by PR Murray. Washington, DC,<br />

ASM Press, 2007, pp 1762-1788.<br />

Cryptococcus Antigen, Serum<br />

Clinical Information: Cryptococcosis is an invasive fungal infection caused by Cryptococcus<br />

neoformans. The organism has been isolated from several sites in nature, particularly weathered pigeon<br />

droppings. Infection is usually acquired via the pulmonary route. Patients are often unaware of any<br />

exposure history. Approximately half of the patients with symptomatic disease have a predisposing<br />

immunosuppressive condition such as AIDS, steroid therapy, lymphoma, or sarcoidosis. Symptoms may<br />

include fever, headache, dizziness, ataxia, somnolence, and cough. In addition to the lungs, cryptococcal<br />

infections frequently involve the central nervous system (CNS), particularly in patients infected with HIV.<br />

Mortality in CNS cryptococcosis may approach 25% despite antibiotic therapy. Untreated CNS<br />

cryptococcosis is invariably fatal. Disseminated disease may affect any organ system and usually occurs<br />

in immunosuppressed individuals.<br />

Useful For: Aiding in the diagnosis of cryptococcosis<br />

Interpretation: The presence of cryptococcal antigen in any body fluid (serum or cerebrospinal fluid:<br />

CSF) is indicative of cryptococcosis. Disseminated infection is usually accompanied by a positive serum<br />

test. The test is less frequently positive in serum than in CSF. Cryptococcal antigen in serum may be<br />

detected by latex agglutination in approximately 30% of infected patients who are asymptomatic. Higher<br />

titers appear to correlate with more severe infections. Declining titers may indicate regression of infection.<br />

However, monitoring titers to cryptococcal antigen should not be used as a test of cure, as low-level titers<br />

may persist for extended periods of time following appropriate therapy and the resolution of infection, as<br />

measured by smear and culture.<br />

Reference Values:<br />

Negative<br />

If positive, results are titered.<br />

Clinical References: 1. Warren NG, Hazen KC: Candida, Cryptococcus, and other yeasts of medical<br />

importance. In Manual of Clinical Microbiology. 7th edition. Edited by PR Murray. Washington, DC,<br />

ASM Press, 1999, pp 1184-1199 2. Lu H, Zhou Y, Yin Y, et al: Cryptococcal antigen test revisited:<br />

significance for cryptococcal meningitis therapy monitoring in a tertiary Chinese hospital. J Clin<br />

Microbiol 2005 June;43(6):2989-2990<br />

Cryptococcus Antigen, Spinal Fluid<br />

28072<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 553

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