Evaluation of a Cryptococcus capsular polysaccharide detection FungiXpert LFA (lateral flow assay) for the rapid diagnosis of Cryptococcosis.

Cryptococcus is an opportunistic pathogenic fungus and is the major cause of fungal meningitis. The cryptococcal antigen (CrAg) lateral flow assay (LFA) is an immunochromatographic test system that has simplified diagnosis as a point-of-care test. In this study, we evaluated the diagnostic performance of Cryptococcal capsular polysaccharide detection FungiXpert (Genobio Pharmaceutical, Tianjin, China) using serum and cerebrospinal fluid (CSF) samples for the diagnosis of cryptococcosis and investigated the cross-reaction of the assays to pathogenic fungi and bacterium by comparing it to the U.S. Food and Drug Administration (US FDA)-approved IMMY CrAg LFA. Eighty CSF and 119 serum/plasma samples from 158 patients were retrospectively collected to test for qualitative or semi-quantitative detection of CrAg. Cross-reaction of the assays was tested using 28 fungi and 1 bacterium. Compared to IMMY CrAg LFA, the FungiXpert LFA demonstrated 99.1% sensitivity and 98.9% specificity in the qualitative test. In the 96 semi-quantitative CrAg assay results, 39 (40.6%) test titers of FungiXpert LFA were 1-2 dilutions higher than those of IMMY CrAg LFA. The Intraclass Correlation Coefficient of the Semi-quantitative results of CrAg titer tests via the two assays was 0.976. Similar to IMMY CrAg LFA, FungiXpert LFA showed cross-reactivity with Trichosporon asahii. Compared with the IMMY CrAg LFA, the FungiXpert LFA showed an equal, yet, excellent performance. However, it is important to note that these two assays have potential cross-reactivity to T. asahii when diagnosing patients. FungiXpert LFA is a rapid screening method for the effective and practical diagnosis and treatment of cryptococcosis. LAY SUMMARY: The FungiXpert LFA was developed to diagnose fungal meningitis caused by Cryptococcus yeasts, by using serum or cerebrospinal fluid. It was compared to an existing lateral flow assay (LFA). The FungiXpert LFA performed well in qualitative and semi-quantitative tests.

Rhinocerebral Zygomycosis Due to a Lichtheimia ramosa Infection in a Calf: Neural Spread Through the Olfactory Nerves.

Here, we report a case of rhinocerebral zygomycosis due to a Lichtheimia ramosa infection in a calf. A histopathological examination revealed that a fungus had invaded the brain through the olfactory nerves. Lichtheimia ramosa was detected by polymerase chain reaction analysis of DNA extracted from formalin-fixed paraffin-embedded samples of the affected tissue. This is the first case of rhinocerebral zygomycosis to involve cattle. Also, this is the first such case to involve fungal invasion into the central nervous system through the cranial nerve itself, rather than through perineural tissue.

Cerebral phaeohyphomycosis due to Cladophialophora bantiana in a Huacaya alpaca (Vicugna pacos).

Cerebral phaeohyphomycosis, caused by Cladophialophora bantiana, was diagnosed in a Huacaya alpaca (Vicugna pacos). An 8-year-old, intact male Huacaya alpaca from a farm in Indiana was found dead at pasture and submitted to the Animal Disease Diagnostic Laboratory at Purdue University for necropsy examination. Gross lesions were limited to the cerebrum, which had a 2×2.5×5 cm, well-demarcated, firm, mottled, pale grey to brown-red mass with a granular texture, centered on the left and right cingulate gyri. Microscopically, granulomatous and necrotizing meningoencephalitis with intralesional pigmented fungal hyphae effaced the cerebral grey and white matter of the cingulate gyri. The hyphae were 4-6 µm in diameter and septate, with non-parallel walls and occasional branching. Polymerase chain reaction for the internal transcribed spacer-1 of the nuclear small-subunit ribosomal RNA genes was performed on extracts from formalin-fixed and paraffin wax-embedded sections of cerebrum. Nucleotide sequence analysis of the amplified fragment identified the fungal agent as C. bantiana. This is the first report of cerebral phaeohyphomycosis attributable to C. bantiana in a camelid.

A novel case of Fusarium oxysporum infection in an Atlantic bottlenose dolphin (Tursiops truncatus).

A necropsy was performed on a captive-born, 10-yr-old male Atlantic bottlenose dolphin (Tursiops truncatus) after it died acutely. Gross necropsy findings revealed hemorrhage within the right cerebrum, right cerebellum, and right eye. Histopathologic findings revealed a moderate multifocal acute necrotizing meningoencephalitis with intralesional fungal hyphae. Several pieces of cerebrum and cerebellum and cerebrospinal fluid were sent to the Fungus Testing Laboratory in San Antonio, Texas (U.S.A.). The culture yielded Fusarium oxysporum, which was confirmed by internal transcribed spacer and D1-D2 sequencing. Fusarium oxysporum infection has been reported in marine mammals. No cases of noncutaneous F. oxysporum infection in a cetacean that was not on long-term antimicrobials have been reported in the literature.