Journal of Fungi (Apr 2023)

Evaluation of Five Non-Culture-Based Methods for the Diagnosis of Meningeal Sporotrichosis

  • Fernando Almeida-Silva,
  • Marcos de Abreu Almeida,
  • Vanessa Brito de Souza Rabello,
  • Rosely Maria Zancopé-Oliveira,
  • Lilian Cristiane Baeza,
  • Cristiane da Cruz Lamas,
  • Marco Antonio Lima,
  • Priscila Marques de Macedo,
  • Maria Clara Gutierrez-Galhardo,
  • Rodrigo Almeida-Paes,
  • Dayvison Francis Saraiva Freitas

DOI
https://doi.org/10.3390/jof9050535
Journal volume & issue
Vol. 9, no. 5
p. 535

Abstract

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Sporotrichosis is the main subcutaneous mycosis worldwide. Several complications, including meningeal forms, can be observed in immunocompromised individuals. The sporotrichosis diagnosis is time-consuming due to the culture’s limitations. The low fungal burden in cerebrospinal fluid (CSF) samples is another important drawback in the diagnosis of meningeal sporotrichosis. Molecular and immunological tests can improve the detection of Sporothrix spp. in clinical specimens. Therefore, the following five non-culture-based methods were evaluated for the detection of Sporothrix spp. in 30 CSF samples: (i) species-specific polymerase chain reaction (PCR); (ii) nested PCR; (iii) quantitative PCR; (iv) enzyme-linked immunosorbent assay (ELISA) for IgG detection; and (v) ELISA for IgM detection. The species-specific PCR was unsuccessful in the diagnosis of the meningeal sporotrichosis. The other four methods presented substantial levels of sensitivity (78.6% to 92.9%) and specificity (75% to 100%) for the indirect detection of Sporothrix spp. Both DNA-based methods presented similar accuracy (84.6%). Both ELISA methods were concomitantly positive only for patients with sporotrichosis and clinical signs of meningitis. We suggest that these methods should be implemented in clinical practice to detect Sporothrix spp. in CSF early, which may optimize treatment, augment the chances of a cure, and improve the prognosis of affected individuals.

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