Detection of anti-Candida antibodies by the indirect immunofluorescence assay in patients with cancer in the orofacial region

Yeast central nervous system infection in a critically ill patient: a case report

Introduction

Invasive fungal infections are alarmingly common in intensive care unit patients; invasive fungal infections are associated with increased morbidity and mortality. Risk factors are the increased use of indwelling central venous catheters, the use of broad spectrum antibiotics, parenteral nutrition, renal replacement therapy and immunosuppression. Diagnosis of these infections might be complicated, requiring tissue cultures. In addition, therapy of invasive fungal infections might be difficult, given the rising resistance of fungi to antifungal agents.

Case presentation

We describe the case of a 28-year-old Greek man with yeast central nervous system infection.

Conclusions

Difficult-to-treat fungal infections may complicate the clinical course of critically ill patients and render their prognosis unfavorable. This report presents a case that was rare and difficult to treat, along with a thorough review of the investigation and treatment of these kinds of fungal infections in critically ill patients.

[Evaluation of a new commercial test (Candida albicans IFA IgG) for the serodiagnosis of invasive candidiasis]

INTRODUCTION

Two tests for the detection of antibodies to Candida albicans germ tubes in patients with invasive candidiasis were compared: a new commercially available test (Candida albicans IFA IgG) and the indirect immunofluorescence test generally used for this purpose.

METHODS

With the use of two indirect immunofluorescence tests, retrospective study was done on 172 sera from 51 patients classified into two groups: Group I included 123 serum samples from 32 patients with invasive candidiasis, and Group II, the control, included 49 serum samples from 19 patients with no evidence of Candida infection.

RESULTS

In Group I, 84% of patients presented anti-germ tube antibody titers >or= 1:160 by the Candida albicans IFA IgG test and 78.1% of patients were positive by the generally used test. There was a high correlation between the two tests (R2 =0.9512 by patients; R2 = 0.8986 by sera). When a titer value of >or= 1:160 was used as cutoff, the Candida albicans IFA IgG test showed a sensitivity of 84.4% and a specificity of 94.7%, whereas the traditional test showed a sensitivity of 78.1% and a specificity of 100%.

CONCLUSIONS

The commercially available Candida albicans IFA IgG test is similar to the test generally used for the detection of antibodies to C. albicans germ tubes and provides faster and easier diagnosis of invasive candidiasis in the clinical microbiology laboratory.

The detection of anti-Candida antibodies on experimental animal models

The levels of anti-Candida antibodies were determined in experimental animals immunized with 4 different yeast doses (0.3, 0.6, 1.2, 2.4 x 10(8) CFU) at weekly intervals. After immunization (sampling intervals 1, 2, and 3 months), the intravenous blood was examined for the presence of serum anti-Candida antibodies. After one month, the titers of anti-Candida antibodies reached 1:40-1: 1280 and remained at the same level after two months in the majority of animals; only in a few of them the titers increased or were detected de novo. After three months, when the animals were no longer immunized, a decreasing trend in antibody titers was detected in the majority of animals.