Cerebrospinal fluid Histoplasma antibodies in central nervous system histoplasmosis

Abstract

The Histoplasma antibody response in the CSF was evaluated in 9 patients with CNS histoplasmosis and 98 controls. While the CSF Histoplasma antibody response identified 8 of the 9 patients, CSF cultures were positive in only 2. Of controls with histoplasmosis but without meningitis (13 patients) or without histoplasmosis (85 patients), elevated CSF antibodies were detected by complement fixation in 7, by IgG radioimmunoassay in 17 and by IgM radioimmunoassay in 5. Measurement of the CSF Histoplasma antibody response appears useful for identifying meningitis in patients with histoplasmosis, although cross-reactions occur in 1/2 of the patients with other forms of chronic fungal meningitis. Patients with these other infections can usually be identified by tests for CSF Coccidioides antibodies or cryptococcal antigens.