Assuntos
Infecções Fúngicas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Reação em Cadeia da Polimerase , Esporotricose/líquido cefalorraquidiano , Esporotricose/diagnóstico , Adulto , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Líquido Cefalorraquidiano/microbiologia , Feminino , Humanos , Masculino , Sporothrix , Esporotricose/microbiologiaRESUMO
We performed a serological study with sera from 92 patients with confirmed sporotrichosis registered between 1999 and 2004 in two hospitals in Rio de Janeiro State, Brazil. The clinical presentation of sporotrichosis was distributed as follows: lymphocutaneous, 67%; fixed cutaneous, 23%; disseminated cutaneous, 8%; and extracutaneous, 2%. Sera were assayed by ELISA against a cell wall antigen of Sporothrix schenckii, SsCBF, that we have previously described. The cross-reactivity was determined with 77 heterologous sera. The serological test showed a sensitivity of 90% and a global efficiency of 86%. A group of 55 patients with several clinical presentations of sporotrichosis was clinically and serologically followed-up for at least 6 months. We observed by ELISA data a decrease in the antibody serum titers which correlated with the progress in healing. An HIV-positive patient with meningeal sporotrichosis was serologically followed-up for over 2 years. Serum and cerebrospinal fluid specimens were examined and significant antibodies levels against the antigen SsCBF were detected. Our results strongly suggest that this serological test is valuable for the differential diagnosis and follow-up of all clinical forms of sporotrichosis.
Assuntos
Antígenos de Fungos/química , Ensaio de Imunoadsorção Enzimática/métodos , Sporothrix/crescimento & desenvolvimento , Esporotricose/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Anticorpos Antifúngicos/sangue , Anticorpos Antifúngicos/líquido cefalorraquidiano , Parede Celular , Glicopeptídeos/química , Infecções por HIV/microbiologia , Humanos , Proteínas de Plantas , Sensibilidade e Especificidade , Esporotricose/sangue , Esporotricose/líquido cefalorraquidianoRESUMO
Cerebrospinal fluid lymphocytes from 13 patients with nonsuppurative meningitis were cultured with antigens derived from Mycobacterium tuberculosis, Sporotrichum schenckii, and herpes simplex. When CSF lymphocytes from five patients with infections associated with these organisms were incubated with "correct" antigen there was increased incorporation of thymidine. The levels were higher than those seen when the cells were incubated with different antigens or when CSF lymphocytes from patients with other causes for their meningitis were cultured with these antigens. A compartmentalization of antigen-specific cells was suggested as CSF lymphocytes had greater stimulation than did peripheral blood lymphocytes from the same patient when incubated with the correct antigen. Transformational assays of CSF lymphocytes may provide a valuable diagnostic aid in certain cases of chronic meningitis.