Experience with the use of pronase to eliminate interference factors in the latex agglutination test for cryptococcal antigen

Abstract

Cryptococcal antigen titers of 70 cerebrospinal fluid and 57 serum specimens from patients suspected of having cryptococcosis were determined both before and after treatment with pronase. Median titers of cerebrospinal fluid specimens before and after treatment were 128 and 128, respectively; mean geometric titers of these specimens before and after treatment were 102 and 204, respectively. Median titers of the serum specimens before and after treatment were 16 and 512, respectively; mean geometric titers of these specimens before and after treatment were 19 and 631, respectively. The modified latex agglutination test did not detect antigen in any of 50 cerebrospinal fluid and 51 serum specimens from patients not suspected of having cryptococcosis. These results suggest that the pronase modification increases the sensitivity of the latex agglutination test and that the modification be routinely incorporated into it.