Title

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

Document Type

Article

Publication Date

12-1-2016

Publication Title

Infection

Abstract

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.

Medical Subject Headings

Antigens, Fungal; Cryptococcosis; Cryptococcus; Endocarditis; False Positive Reactions; Female; Humans; Lupus Erythematosus, Systemic; Middle Aged

PubMed ID

27246719

Volume

44

Issue

6

First Page

803

Last Page

805

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