[Immunodiagnosis and blood biochemical diagnosis of visceral candidiasis and the cutoff limits of positive]

Abstract

Visceral candidiasis is nonspecific in the clinical presentation and a microbiological diagnosis is often difficult to make. Currently, several techniques are available for detection of the antigen and antibody and/or fungal product. We report the results of an investigation in immunodiagnosis and blood biochemical diagnosis of visceral candidiasis and suggest the cutoff limits of positive, from these findings and those reported by others. The efficiency and specificity were 36.4% approximately 60% and 94% approximately 100% for the mannan detection kit from Kyokuto Co., Ltd. and 57.1% approximately 100% and 25% approximately 69.6% for the CAND-TEC, and 28.6% and 91.7% for PASTOREX CANDIDA. For kits using a blood biochemical assay; the efficiency and specificity were 10% approximately 56.7% and 91.4% approximately 100% with detection of D-arabinitol (cutoff limits; 20 mumol/ml < or =), and 70% approximately 75% and 91.7% approximately 100% for Fungal Index (cutoff limits; 60pg/ml < or =). We investigated the evaluation of LA test to detect candidal mannan antigen in sera obtained from experimental gastric candidiasis of mice with or without treatment. There was a good correlation between the change of the titer of mannan antigen and the severity of infections, and gastric lesions healed histopathologically 3 weeks after disappearance of mannan antigen in sera obtained from mice treated with an antifungal agent. These findings indicate that the antifungal therapy is necessary for more than 3 weeks after the candidal mannan antigen disappeared from sera.