Evaluation of galactomannan and 1,3-β-d-glucan assays as diagnostic tools for intracranial fungal infection: A case series

Abstract

Fungal infections of the central nervous system have dramatically surged over the past decade, particularly in semitropical regions such as Karachi. Herein, we retrospectively evaluated the diagnostic potential of galactomannan (GM) and 1,3-β-d-glucan (BDG) assays for intracranial fungal infections (IFI) at a tertiary care facility in Karachi. A total of 12 patients (3 immunocompromised and 9 immunocompetent) aged 18 - 60 years underwent serum fungal biomarker testing, imaging studies, and cerebrospinal fluid (CSF) analysis. Suboptimal GM and high BDG titers indicated invasive mycoses. Computed tomography scan revealed fungal sinusitis, and magnetic resonance imaging revealed brain parenchyma involvement. Fungal biomarkers helped rule out a neoplastic etiology. Normal GM and high BDG titers negated the probability of aspergillosis. Further, culture tests helped identify the causative organisms and tailor the treatment. Our findings emphasize the diagnostic value of GM and BDG assays in IFIs. Furthermore, we recommend the use of CSF specimens for fungal biomarker assays in future diagnostic protocols.

Keywords

Intracranial fungal infection / Galactomannan / Fungal sinusitis / d-glucan / 1-3-β-d-glucan

Funding

None.

Conflict of interest

The authors declare that they have no competing interests.

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