{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T03:56:23Z","timestamp":1754020583108,"version":"3.37.3"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["AI001123","AI001124"],"award-info":[{"award-number":["AI001123","AI001124"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["RO1AI127704","RO1AIO59681","T32AI055433","U01AI089244","UO1AI109657"],"award-info":[{"award-number":["RO1AI127704","RO1AIO59681","T32AI055433","U01AI089244","UO1AI109657"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Antibody detection is commonly used for diagnosis of histoplasmosis, and cross\u2010reactions have been recognised due to endemic mycoses but not cryptococcosis. We observed cross\u2010reactions in an anti\u2010<jats:italic>Histoplasma<\/jats:italic> antibody enzyme immunoassay (<jats:styled-content style=\"fixed-case\">EIA<\/jats:styled-content>) in the cerebrospinal fluid (<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) from a patient with cryptococcal meningitis and sought to assess the risk of cross\u2010reactive anti\u2010<jats:italic>Histoplasma<\/jats:italic> antibodies in persons with cryptococcal meningitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An anti\u2010cryptococcal antibody <jats:styled-content style=\"fixed-case\">EIA<\/jats:styled-content> was developed to measure <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> antibody response in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected subjects from Kampala, Uganda and previously healthy, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010negative subjects at the National Institutes of Health (<jats:styled-content style=\"fixed-case\">NIH<\/jats:styled-content>) with cryptococcal meningitis. Specimens were tested for cross\u2010reactivity in assays for IgG anti\u2010<jats:italic>Histoplasma<\/jats:italic>, anti\u2010<jats:italic>Blastomyces<\/jats:italic> and anti\u2010<jats:italic>Coccidioides<\/jats:italic> antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 61 subjects with cryptococcal meningitis (44 Kampala cohort, 17 <jats:styled-content style=\"fixed-case\">NIH<\/jats:styled-content> cohort), elevated <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> anti\u2010cryptococcal antibody levels existed in 38% (23\/61). Of the 23 <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> specimens containing elevated anti\u2010cryptococcal antibodies, falsely positive results were detected in antibody <jats:styled-content style=\"fixed-case\">EIA<\/jats:styled-content>s for histoplasmosis (8\/23, 35%), coccidioidomycosis (6\/23, 26%) and blastomycosis (1\/23, 4%). Overall, 2% (2\/81) of control <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> specimens had elevated anti\u2010cryptococcal antibody detected, both from Indiana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cryptococcal meningitis may cause false\u2010positive results in the <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> for antibodies against <jats:italic>Histoplasma, Blastomyces<\/jats:italic> and <jats:italic>Coccidioides<\/jats:italic>. Fungal antigen testing should be performed to aid in differentiating true\u2010 and false\u2010positive antibody results in the <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.12882","type":"journal-article","created":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T11:30:55Z","timestamp":1545219055000},"page":"268-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cryptococcal meningitis is a cause for cross\u2010reactivity in cerebrospinal fluid assays for anti\u2010<i>Histoplasma,<\/i> anti<i>\u2010Coccidioides<\/i> and anti\u2010<i>Blastomyces<\/i> antibodies"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9431-8938","authenticated-orcid":false,"given":"Nathan C.","family":"Bahr","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Kansas  Kansas City Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5524-668X","authenticated-orcid":false,"given":"Anil A.","family":"Panackal","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases National Institutes of Health  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Durkin","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis  Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda L.","family":"Smedema","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis  Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesley","family":"Keown","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics, Indianapolis  Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas E.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University  Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Raymond\u2010Guillen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Indiana University  Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoon\u2010Dong","family":"Park","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases National Institutes of Health  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1051-0376","authenticated-orcid":false,"given":"Kieren A.","family":"Marr","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Department of Medicine Johns Hopkins  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-5518","authenticated-orcid":false,"given":"Bettina C.","family":"Fries","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Department of Medicine Stony Brook School of Medicine  Stony Brook New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter R.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases National Institutes of Health  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-0060","authenticated-orcid":false,"given":"David R.","family":"Boulware","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease and International Medicine Department of Medicine University of Minnesota  Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. 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