XI International Meeting on Paracoccidioidomycosis

XI International Meeting on Paracoccidioidomycosis

Resume:45-5

Poster (Painel)

45-5	COMPARISON OF MYCOLOGICAL AND IMMUNOLOGICAL METHODS IN PARACOCCIDIOIDOMYCOSIS DIAGNOSIS.
Authors:	Camila Mika Kamikawa (IAL - Instituto Adolfo Lutz) ; Valdelene Sayuri Kohara (IAL - Instituto Adolfo Lutz) ; Angela Noronha Passos (IAL - Instituto Adolfo LutzPG-CCD-SES-SP - Programa de Pos Graduacao em Ciencias (PG-CCD-SES-SP)) ; Adriana Pardini Vicentini (IAL - Instituto Adolfo Lutz)

Abstract

Definitive diagnosis of paracoccidioidomycosis (PCM) is based on the isolation and identification of etiological agent in biological fluids or tissue fragments; however, sometimes immunodiagnosis is the first evidence of fungal infection. We evaluated the correlation between the results obtained by the P. brasiliensis (Pb)survey accomplished through direct examination of sputum samples at Instituto Adolfo Lutz de Sorocaba and by antibodies anti-P. brasiliensis detection by double immunodiffusion (DI) assay performed at Instituto Adolfo Lutz de Sao Paulo (IAL-SP) in patients with clinical suspicion of PCM from Sorocaba city. Information regarding mycological and immunological results were taken from the Information System and Hospital Management (SIGH-Lab) and from Database of Laboratorio de Imunodiagnostico das Micoses, IAL-SP. We analyzed 220 patients with serum samples sent to IAL-SP, from april 2009 to december 2010. We found that 10.4% had, besides the request for research antibodies, requests for research of Pb in sputum and⁄or diagnosing other diseases. Nine patients showed agreement in results, ie absence of P.brasiliensis yeasts on direct examination and absence of specific antibodies in serum samples by DI. Three individuals had positive mycological examination with visualization of yeast cells and antibody detection in the serum, and one patient with negative result for direct examination showed reactivity to P. brasiliensis by serological analysis. Two samples submitted for culture showed no growth of P. brasiliensis, and the corresponding sera also showed no reactivity by DI assay. Six individuals showed reactivity by serological assay for Leishmania sp and absence of reactivity to Pb using complementary techniques to confirm the disease, especially for patients with negative results by mycological tests and that can often have the confirmation made by immunological assays, as well as to differentiate it of others diseases with similar clinical and epidemiological signs, as in the case of leishmaniasis, a disease that presents as the PCM also highly endemicity in Sao Paulo. We observed that the use of DI assay, showed the same performance shown by direct examination, considered as gold standard method, confirming the sensitivity and specificity of DI assay.

Keyword: Direct examination, Double immunodiffusion assay, Mycological diagnosis, Paracoccidioidomycosis

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