TABLE 1.
Characteristics of studies reporting the use of beta-d-glucan measurement in cerebrospinal fluid as a diagnostic test for fungal meningitisa
| Outcome(s) measured | No. of controls | No. of cases | Organism | Study type or objective | Country/ies | Type of study | Cohortb |
|---|---|---|---|---|---|---|---|
| CSF BDG persistence | NA | 1 | Candida tropicalis | Descriptive | USA | Case report | Ceccarelli et al. (21) |
| CSF BDG | NA | 1 | Aspergillus spp. | Descriptive | USA | Case report | Chen et al. (34)c |
| Sensitivity | 66 | 108 (41 definite, 67 probable) | Exserohilum rostratum | Diagnostic accuracy and response to treatment | USA | Case-control | Litvintseva et al. (22) |
| CSF BDG | NA | 1 | Candida sp. | Descriptive | USA | Case report | Lyons et al. (33)c |
| NA | NA | 5 | Unknown | Descriptive | USA | Case series | Lyons et al. (23) |
| NA | 66 | 9 | Cryptococcus spp., Histoplasma spp., Exserohilum spp. | Diagnostic accuracy | USA | Case-control | Lyons et al. (32) |
| Specificity, sensitivity | 153 | 47 | Histoplasma spp. | Diagnostic accuracy | USA | Case-control | Myint et al. (24)d |
| Specificity, sensitivity, decline over time | 39 | 78 | Cryptococcus spp. | Diagnostic accuracy and response to treatment | Uganda, South Africa | Case-control | Rhein et al. (25) |
| Specificity, sensitivity, PPV, NPV, decline over time | 11 | 26 | Coccidioides spp. | Diagnostic accuracy | USA | Case-control | Stevens et al. (26) |
| CSF BDG | 19 | 5 (n = 3, Aspergillus spp.; n = 1, Histoplasma sp.; n = 1, Cryptococcus sp.) | Aspergillus spp., Histoplasma sp., Cryptococcus sp. | Descriptive | USA | Case-control | Mikulska et al. (27) |
| Sensitivity, specificity | 135 | 28 (n = 1, Aspergillus spp.; n = 27, Exserohilum spp.) | Exserohilum rostratum, Aspergillus sp. | Diagnostic accuracy | USA | Case-control | Malani et al. (28) |
| CSF BDG | NA | 9 (n = 7, Candida spp.; n = 2, Aspergillus spp.) | Candida spp., Aspergillus spp. | Descriptive | USA | Case series | Salvatore et al. (29) |
| CSF BDG | NA | 1 | Phaeohyphomycosis (exact pathogen unclear) | Descriptive | USA | Case report | Nelson et al. (30) |
| CSF BDG | NA | 2 | Aspergillus spp. | Descriptive | USA | Case series | Morgand et al. (31) |
a
CSF, cerebrospinal fluid; BDG, beta-d-glucan; NA, not available; PPV, positive predictive value; NPV, negative predictive value.
b
Sensitivity/specificity values are reported in Table 2 when available.
c
Study did not specify the assay used; all others reported use of the Fungitell assay.
d
This study had among its controls 13 cases of other fungal meningitis including meningitis due to Cryptococcus (n = 5), Blastomyces (n = 3), Candida (n = 2), Aspergillus (n = 2), and Coccidioidomyces (n = 1).