[The value of immunological assays in the diagnosis of meningeal histoplasmosis].

INTRODUCTION

Between 1985 and 1995, 3,860 cerebrospinal fluid (CSF) samples from patients with mycotic meningitis were analyzed.

METHODS

Direct examination, cultures, complement fixation (CF) and immunodiffusion (ID) with Histoplasma capsulatum were carried out.

RESULTS

Seventy four samples from 31 patients (three of them with AIDS) were reactive at the immunological assays. Cultures were positive in five patients. In 26 patients the clinical diagnosis together with positive CSF assays gave indirect evidence of meningeal histoplasmosis. ID and CF reactivity were 93.5% and 100% respectively. For 23 patients who had simultaneous examination of blood and CSF the double positivity was 78.2%.

CONCLUSIONS

Because of the direct isolation of Histoplasma capsulatum is a difficult one, the diagnosis of subacute or chronic meningeal histoplasmosis may be confirmed by indirect immunological assays.