Role of PCR in Diagnosis of Cryptococcal meningitis.

What is it about?

Cryptococcus neoformans, a common fungal pathogen of the central nervous system, results in high morbidity and mortality, unless diagnosed early and specific treatment instituted. The efficacy of the currently available tests for diagnosis (i.e. microscopy and latex agglutination test) are limited. The purpose of the present study was to evaluate a polymerase chain reaction (PCR) test (using CN5/CN4primers) for the diagnosis of cryptococcal meningitis. The PCR was evaluated using culture as the gold standard and results compared with those obtained by microscopy and latex agglutination. In the present study 55(49.54%) had laboratory confirmed cryptococcal meningitis (either smear/CALAS/culture/PCR positive). The sensitivity of PCR, antigen detection test and microscopy was 100%, 89.19% and 78.4% respectively while the specificity of these tests was 82.43%, 85.14% & 90% respectively. The positive predictive value of the PCR was 74% and the negative predictive value was 100%.

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Why is it important?

The PCR technique proved to be a rapid and reliable technique for the early diagnosis of cryptococcal meningitis. This may help for early management of patient especially in immunocompromised one.

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