(1→3)-β-d-glucan in cerebrospinal fluid as a biomarker for Candida and Aspergillus infections of the central nervous system in pediatric patients

Christine M. Salvatore, Tempe K. Chen, Sima S. Toussi, Patricia DeLaMora, Ruta Petraitiene, Malcolm A. Finkelman, Thomas J. Walsh

Research output: Contribution to journalArticle

Abstract

Background: Fungal infections of the central nervous system (FICNS) are important causes of morbidity and mortality among immunocompromised pediatric patients. Standard diagnostic modalities lack the sensitivity for detecting and therapeutically monitoring these life-threatening diseases. Current molecular methods remain investigational. (1→3)-β-d-glucan (BDG) is a cell wall component found in several fungal pathogens, including Candida and Aspergillus spp. Detecting BDG in cerebrospinal fluid (CSF) may be an important approach for detecting and therapeutically monitoring FICNS. To date, there has been no study that has investigated the effectiveness of CSF BDG as a diagnostic and therapeutic marker of FICNS in children. Methods: Serial BDG levels were measured in serum and CSF samples obtained from pediatric patients (aged 0-18 years) with a diagnosis of probable or proven Candida or Aspergillus CNS infection. Results: Nine cases of FICNS were identified in patients aged 1 month to 18 years. Two patients were infected with an Aspergillus species, and 7 patients were infected with a Candida species. All the patients at baseline had detectable BDG in their CSF. Among 7 patients who completed therapy for an FICNS, all elevated CSF BDG levels decreased to <31 pg/mL. At the time of this writing, 1 patient was still receiving therapy and continued to have elevated BDG levels. One patient died from overwhelming disseminated candidiasis. The lengths of therapy for these 9 children ranged from 2 weeks to 28 months. Conclusion: The BDG assay is useful in diagnosing and therapeutically monitoring Candida and Aspergillus CNS infections in pediatric patients.

Original languageEnglish (US)
Article numberpiv014
Pages (from-to)277-286
Number of pages10
JournalJournal of the Pediatric Infectious Diseases Society
Volume5
Issue number3
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Keywords

  • (1→3)-β-d-glucan
  • Central nervous system
  • Children
  • Fungal infection

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of '(1→3)-β-d-glucan in cerebrospinal fluid as a biomarker for Candida and Aspergillus infections of the central nervous system in pediatric patients'. Together they form a unique fingerprint.

  • Cite this