{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:49:34Z","timestamp":1788918574666,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The incidence of <jats:italic>Aspergillus<\/jats:italic> and <jats:italic>Candida<\/jats:italic> CNS infection, which are characterised by high mortality rates, is underestimated. This underdiagnosis presumably results from the limitations of available diagnostic tools and the need for invasive sampling. Little is known about the role of serologic biomarkers in the setting of CNS aspergillosis and candidiasis.<\/jats:p><jats:p>Patients, materials and methods: Serum and cerebrospinal fluid (CSF; 10) samples of 19 patients, whose CNS specimens yielded growth of <jats:italic>Aspergillus<\/jats:italic> or <jats:italic>Candida<\/jats:italic>, were analysed for different biomarkers for fungal infection, that is galactomannan (GM), galactomannoprotein (GP), mannan, anti\u2010mannan\u2010antibodies and \u03b2\u20101,3\u2010D\u2010glucan (BDG). Serum and CSF specimens of time\u2010matched patients (two each for every case of fungal CNS infection) were included as controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Galactomannan, GP and BDG seropositivity was found in one, two and three of five cases of CNS aspergillosis. BDG and mannan\/anti\u2010mannan\u2010antibody sensitivity in proven CNS candidiasis was 40% and 20%, respectively. Applying the serum cut\u2010off, sensitivity in CSF testing was 100% for GM and BDG and 50% for mannans. While serum specificity for all assays ranged from 89 to 97%, specificity for CSF BDG was only 70%. No false\u2010positive GM results from CSF were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sensitivity for diagnosing CNS aspergillosis and CNS candidiasis from serum is mediocre for all serological biomarkers. GM testing in CSF proved excellent performance. With a sensitivity of 100% but a specificity of only 70%, CSF BDG might be most useful when used in patients with a high pre\u2010test probability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13451","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T14:40:30Z","timestamp":1651675230000},"page":"709-714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Serologic biomarkers in <i>Candida<\/i> and <i>Aspergillus<\/i> infections of the central nervous system: A comparison of galactomannan, mannan and \u03b2\u20101,<scp>3\u2010D<\/scp>\u2010gucan testing from serum and cerebrospinal fluid"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8138-5891","authenticated-orcid":false,"given":"Johannes","family":"Forster","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Hygiene und Mikrobiologie Julius\u2010Maximilians\u2010Universit\u00e4t W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hoenigl","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine Medical University of Graz  Graz Austria"},{"name":"Division of Infectious Diseases and Global Public Health University of California San Diego  San Diego USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Suerbaum","sequence":"additional","affiliation":[{"name":"Max von Pettenkofer\u2010Institut f\u00fcr Hygiene und Medizinische Mikrobiologie Medizinische Fakult\u00e4t, LMU M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5952-9422","authenticated-orcid":false,"given":"Johannes","family":"Wagener","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Hygiene und Mikrobiologie Julius\u2010Maximilians\u2010Universit\u00e4t W\u00fcrzburg  W\u00fcrzburg Germany"},{"name":"Department of Clinical Microbiology St. James's Hospital  Dublin Ireland"},{"name":"Department of Clinical Microbiology, School of Medicine Trinity College Dublin, The University of Dublin, St. James's Hospital Campus  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5032-8870","authenticated-orcid":false,"given":"Karl","family":"Dichtl","sequence":"additional","affiliation":[{"name":"Max von Pettenkofer\u2010Institut f\u00fcr Hygiene und Medizinische Mikrobiologie Medizinische Fakult\u00e4t, LMU M\u00fcnchen  Munich Germany"},{"name":"Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine Medical University of Graz  Graz 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