{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:07:48Z","timestamp":1779084468832,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The (1,3)-\u03b2-D-glucan (BDG) assay, commonly referred to as the G test, is influenced by numerous factors and is prone to false-positive and false-negative results, particularly false positives, which pose significant challenges for clinical diagnosis and treatment of invasive fungal diseases (IFDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a patient with a non-healing wound and enterocutaneous fistula following abdominal wall hernia surgery, who responded effectively to antifungal therapy for fungal sepsis. Despite persistently negative blood cultures, the (1,3)-\u03b2-D-glucan (G-test) remained positive for three consecutive months. Through systematic exclusion of confounding factors, including antibiotics, bacterial infections, blood products, fungal preparations, and specimen-related issues, the persistent elevation in G test results was ultimately attributed to contamination by medical sterile gauze. The patient eventually recovered from fungal sepsis and was discharged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>When microbiological evidence for infection is insufficient and clinical symptoms improve with a clear therapeutic response, yet the G test remains persistently positive at high levels over an extended period, careful analysis of potential causes is essential. The G test result should not be blindly used as an indication for antifungal therapy. Medical sterile gauze, cotton swabs, and cotton balls contain high concentrations of BDG, which may lead to false-positive results and should be carefully considered during differential diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1813946","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:42:59Z","timestamp":1779082979000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["False-positive beta-glucan test due to beta-glucan component in sterile gauze during treatment of fungal sepsis: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yi","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Science, Shenzhen Yantian District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shenzhen Yantian District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiling","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Science, Shenzhen Yantian District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ChunLei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Science, Shenzhen Yantian District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"CD009833","DOI":"10.1002\/14651858.CD009833.pub2","article-title":"(1\u21923)-\u03b2-D-glucan testing for the detection of invasive fungal infections in immunocompromised or critically ill people","volume":"7","author":"White","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and update of the consensus definitions of invasive fungal disease from the European organization for research and treatment of cancer and the mycoses study group education and research consortium","volume":"71","author":"Donnelly","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S233","DOI":"10.1080\/13693780802308454","article-title":"Role of (1\u2013>3)-beta-D-glucan in the diagnosis of invasive aspergillosis","volume":"1","author":"Marty","year":"2009","journal-title":"Med Mycol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3390\/jof7010014","article-title":"Specificity influences in (1\u21923)-\u03b2-d-glucan-supported diagnosis of invasive fungal disease","volume":"7","author":"Finkelman","year":"2020","journal-title":"J Fungi"},{"key":"B5","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1007\/s10156-010-0198-6","article-title":"Clinical viability of Fungitell, a new (1\u21923)-\u03b2-d-glucan measurement kit, for diagnosis of invasive fungal infection, and comparison with other kits available in Japan","volume":"17","author":"Yoshida","year":"2011","journal-title":"J Infect Chemother"},{"key":"B6","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.jinf.2016.09.005","article-title":"1, 3-\u03b2-d-Glucan testing is highly specific in patients undergoing dialysis treatment","volume":"74","author":"Prattes","year":"2017","journal-title":"J Infect"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2834","DOI":"10.1056\/NEJMc053340","article-title":"1, 3-\u03b2-d-glucan in patients receiving intravenous amoxicillin\u2013clavulanic acid","volume":"354","author":"Mennink-Kersten","year":"2006","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1099\/jmm.0.019299-0","article-title":"Difficulties in using 1, 3-\u03b2-D-glucan as the screening test for the early diagnosis of invasive fungal infections in patients with haematological malignancies\u2013high frequency of false-positive results and their analysis","volume":"59","author":"Racil","year":"2010","journal-title":"J Med Microbiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1111\/j.1439-0507.2011.02131.x","article-title":"Does ampicillin-sulbactam cause false positivity of (1,3)-beta-D-glucan assay? A prospective evaluation of 15 patients without invasive fungal infections","volume":"55","author":"Metan","year":"2012","journal-title":"Mycoses"},{"key":"B10","doi-asserted-by":"publisher","first-page":"3450","DOI":"10.1128\/AAC.00658-06","article-title":"Reactivity of (1\u2013>3)-beta-d-glucan assay with commonly used intravenous antimicrobials","volume":"50","author":"Marty","year":"2006","journal-title":"Antimicrob Agents Chemother"},{"key":"B11","doi-asserted-by":"publisher","first-page":"97","DOI":"10.2169\/internalmedicine.43.97","article-title":"Interference of (1\u2013>3)-beta-D-glucan administration in the measurement of plasma (1\u2013>3)-beta-D-glucan","volume":"43","author":"Ishizuka","year":"2004","journal-title":"Intern Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1111\/myc.12432","article-title":"1, 3-\u00df-D-glucan concentrations in blood products predict false positive post-transfusion results","volume":"59","author":"Liss","year":"2016","journal-title":"Mycoses"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1016\/j.cmi.2020.02.036","article-title":"Impact of intravenous and subcutaneous immunoglobulins on false positivity of galactomannan and \u03b2-D-glucan antigenaemia and detection of circulating Aspergillus fumigatus DNA","volume":"26","author":"Bougnoux","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"B14","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.jinf.2017.10.017","article-title":"False positive serum levels of (1\u20133)-\u00df-D-Glucan after infusion of intravenous immunoglobulins and time to normalisation","volume":"76","author":"Egger","year":"2018","journal-title":"J Infect"},{"key":"B15","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1093\/cid\/ciab1028","article-title":"High false-positive rate of (1,3)-\u03b2-D-glucan in onco-hematological patients receiving immunoglobulins and therapeutic antibodies","volume":"75","author":"Tschopp","year":"2022","journal-title":"Clin Infect Dis"},{"key":"B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11150\/kansenshogakuzasshi.91.1","article-title":"The effect of intravenous gamma-globulin reagents on the measurement results of (1\u21923)-\u03b2-D-glucan","volume":"91","author":"Moro","year":"2017","journal-title":"Kansenshogaku Zasshi"},{"key":"B17","doi-asserted-by":"publisher","first-page":"116328","DOI":"10.1016\/j.diagmicrobio.2024.116328","article-title":"Dynamic changes in serum (1-3)-\u03b2-D-glucan caused by intravenous immunoglobulin infusion: a prospective study","volume":"109","author":"Wan","year":"2024","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"115942","DOI":"10.1016\/j.diagmicrobio.2023.115942","article-title":"Impact of intravenous immunoglobulins on serum (1-3)-\u03b2-D-glucan","volume":"106","author":"Wan","year":"2023","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1046\/j.1523-1755.2001.00802.x","article-title":"Influence of various hemodialysis membranes on the plasma (1\u2013>3)-beta-D-glucan level","volume":"60","author":"Kanda","year":"2001","journal-title":"Kidney Int"},{"key":"B20","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.idc.2006.06.009","article-title":"Non\u2013culture-based diagnostics for opportunistic fungi","volume":"20","author":"Mennink-Kersten","year":"2006","journal-title":"Infect Dis Clin North Am"},{"key":"B21","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.jinf.2013.03.017","article-title":"Simultaneous increase in 1, 3-\u03b2-D-glucan and procalcitonin levels in Pseudomonas aeruginosa infection","volume":"67","author":"Koya","year":"2013","journal-title":"J Infect"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1007\/s10096-011-1244-8","article-title":"Reactivity of (1\u21923)-\u03b2-d-glucan assay in bacterial bloodstream infections","volume":"30","author":"Albert","year":"2011","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"B23","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1186\/s12879-017-2370-4","article-title":"Detection of high serum levels of \u03b2-D-glucan in disseminated nocardial infection: a case report","volume":"17","author":"Sawai","year":"2017","journal-title":"BMC Infect Dis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"116184","DOI":"10.1016\/j.diagmicrobio.2024.116184","article-title":"(1-3)-\u00df-D-glucan for the diagnosis of Nocardia infection in solid organ transplant recipients","volume":"108","author":"Paumier","year":"2024","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.diagmicrobio.2014.11.002","article-title":"Cross-reactivity of Nocardia spp. in the fungal (1-3)-\u03b2-d-glucan assay performed on cerebral spinal fluid","volume":"81","author":"Koncan","year":"2015","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1093\/mmy\/myu077","article-title":"Positive (1-3) B-d-glucan and cross reactivity of fungal assays in coccidioidomycosis","volume":"53","author":"Zangeneh","year":"2015","journal-title":"Med Mycol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12653","article-title":"False-positive serum (1,3)-\u03b2-D-glucan elevation due to intake of seaweed in a hematopoietic stem cell transplant recipient","volume":"19","author":"Hashimoto","year":"2017","journal-title":"Transpl Infect Dis"},{"key":"B28","doi-asserted-by":"publisher","first-page":"3271","DOI":"10.3168\/jds.2010-4026","article-title":"Evaluation of yogurt and various beverages as carriers of lactic acid bacteria producing 2-branched (1,3)-\u03b2-D-glucan","volume":"94","author":"Elizaqu\u00edvel","year":"2011","journal-title":"J Dairy Sci"},{"key":"B29","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1111\/myc.13161","article-title":"Glucan rich nutrition does not increase gut translocation of beta-glucan","volume":"64","author":"Hoenigl","year":"2021","journal-title":"Mycoses"},{"key":"B30","doi-asserted-by":"publisher","first-page":"153556","DOI":"10.1016\/j.phymed.2021.153556","article-title":"Natural products targeting the synthesis of \u03b2 (1,3)-D-glucan and chitin of the fungal cell wall. Existing drugs and recent findings","volume":"88","author":"Curto","year":"2021","journal-title":"Phytomedicine"},{"key":"B31","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3390\/jof11020149","article-title":"Species-specific sensitivity and levels of beta-D-glucan for the diagnosis of candidemia\u2014a systematic review and meta-analysis","volume":"11","author":"Ullah","year":"2025","journal-title":"J Fungi"},{"key":"B32","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1620\/tjem.217.117","article-title":"Measurement of (1-3)-beta-D-glucan derived from different gauze types","volume":"217","author":"Kanamori","year":"2009","journal-title":"Tohoku J Exp Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"ofy296","DOI":"10.1093\/ofid\/ofy296","article-title":"Serum 1,3-beta-D-glucan values during and after laparoscopic and open intestinal surgery","volume":"5","author":"Szyszkowitz","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"B34","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/j.1439-0507.2011.02068.x","article-title":"Early serum (1\u21923)-\u03b2-D-glucan levels in patients with burn injury","volume":"55","author":"Shupp","year":"2012","journal-title":"Mycoses"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1813946\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:43:00Z","timestamp":1779082980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1813946\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":34,"alternative-id":["10.3389\/fsurg.2026.1813946"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1813946","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"article-number":"1813946"}}