内臓真菌症の血清学的診断　　臨床検査の立場から

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  • Evaluation of serological test for diagnosis of deep mycoses.

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We investigated the usefulness of serodiagnosis for deep mycoses by counterimmunoelectrophoresis (CIE), passive haemagglutination test (PHA) and latex agglutination test (LA).<br>Six hundred and sixteen sera and 36 cerebrospinal fluids (CSF) obtained from 331 patients including 119 with mycosis, and 88 sera obtained from healthy persons as control were used in this study.<br>Investigations were focused on the detection of an anti-fungal antibody against 4 species of pathogenic fungi (Candida albicans, Aspergillus fumigatus, Cryptococcus neoformans and Rhizopus oryzae) and on Nocardia asteroides in these all specimens, and also cryptococcal circulating antigen for 62 specimens by CIE. Comparative titration studies were also performed on anti-Candida and anti-Aspergillus antibody by PHA in a part of these specimens. In addition, quality and quantity of cryptococcal circulating antigen were analyzed in 56 specimens by LA.<br>A positive indication of anti-Candida antibody in patients with candidiasis was found in 48.5% and 37.9% by CIE and PHA, respectively, and cases where Candida was isolated without evidence of candidiasis were 15-44%.<br>The positive rate of anti-Aspergillus antibody in 39 sera obtained from patients with aspergillosis was 38.5% and 77.3% by CIE and PHA.<br>Anti-cryptococcal antibody and circulating cryptococcal antigen in sera were seen in 30.0% and 50.0% of the cases by CIE, and the positive rate of circulating antigen was 100% in sera and CSF by LA.<br>The clinical condition was correlated with the immunological aspect of these methods in 7 out of 10 cases serially determined.

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