{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:31:19Z","timestamp":1792020679406,"version":"4.4.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Accurate and timely methods for the diagnosis of histoplasmosis in resource-limited countries are lacking. Histoplasma antigen detection by enzyme immunoassay (EIA) is widely used in the United States (US) but not in resource-limited countries, leading to missed or delayed diagnoses and poor outcomes. Lateral flow assays (LFAs) can be used in this setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Frozen urine specimens were submitted to MiraVista diagnostics for antigen testing from 3 medical centers in endemic areas of the US. They were blinded and tested for the MVista Histoplasma LFA. Patients were classified as controls or cases of histoplasmosis. Cases were divided into proven or probable; pulmonary or disseminated; immunocompetent or immunosuppressed; and mild, moderate, or severe.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three hundred fifty-two subjects were enrolled, including 66 cases (44 proven, 22 probable) and 286 controls. Most of the cases were immunocompromised (71%), and 46 had disseminated and 20 had pulmonary histoplasmosis. Four cases were mild, 42 moderate, and 20 severe. LFA and EIA were highly concordant (\u03ba = 0.84). Sensitivity and specificity of the LFA were 78.8% and 99.3%, respectively. LFA sensitivity was higher in proven cases (93.2%), patients with disseminated (91.3%), moderate (78.6%), and severe disease (80%), and those with galactomannan levels &amp;gt;1.8 ng\/mL (97.8%). Specificity was 99.3% in proven cases, 99.3% in patients with moderate or severe disease, and 96.8% in those with galactomannan levels &amp;gt;1.8 ng\/mL. Cross-reactivity was noted with other endemic mycoses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The MVista Histoplasma LFA meets the need for accurate rapid diagnosis of histoplasmosis in resource-limited countries, especially in patients with high disease burden, potentially reducing morbidity and mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab454","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T11:30:43Z","timestamp":1630409443000},"source":"Crossref","is-referenced-by-count":40,"title":["Diagnosis of Histoplasmosis Using the MVista <i>Histoplasma<\/i> Galactomannan Antigen Qualitative Lateral Flow\u2013Based Immunoassay: A Multicenter Study"],"prefix":"10.1093","volume":"8","author":[{"given":"Wassim","family":"Abdallah","sequence":"first","affiliation":[{"name":"Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thein","family":"Myint","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"LaRue","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Minderman","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suphansa","family":"Gunn","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L Joseph","family":"Wheat","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadi A","family":"Hage","sequence":"additional","affiliation":[{"name":"Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,31]]},"reference":[{"key":"2021092115315901600_CIT0001","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1055\/s-0039-1698429","article-title":"Current concepts in the epidemiology, diagnosis, and management of histoplasmosis syndromes","volume":"41","author":"Azar","year":"2020","journal-title":"Semin Respir Crit Care Med"},{"key":"2021092115315901600_CIT0002","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1164\/rccm.201906-1185ST","article-title":"Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice. 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