Rhodococcus induced false-positive galactomannan (GM), a biomarker of fungal presentation, in patients with peritoneal dialysis: case reports

BMC Nephrol. 2019 Dec 2;20(1):445. doi: 10.1186/s12882-019-1642-1.

Abstract

Background: Galactomannan index (GMI) at a level higher than 0.5 provides high sensitivity and specificity for the diagnosis of fungal peritonitis. Here, we report the false-positive of GMI in peritoneal dialysis (PD) effluent (PDE) due to Rhodococcus peritonitis in PD patients.

Case presentation: GMI in PDE of case #1 and case #2 were 1.53 and 0.76, respectively, while serum GMI of both cases was less than 0.5. In addition, GMI from the specimens obtained directly from the stationary phase of Rhodococcus colonies were 1.27 and 1.56, which were isolated from case #1 and #2, accordingly.

Conclusion: High GMI in PDE of PD patients is not specific just for fungal infections but may also be secondary to other infections, such as Rhodococcus spp., especially in endemic areas.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actinomycetales Infections* / diagnosis
  • Actinomycetales Infections* / etiology
  • Aged
  • Biomarkers / analysis
  • Diagnosis, Differential
  • False Positive Reactions
  • Galactose / analogs & derivatives
  • Humans
  • Male
  • Mannans / isolation & purification*
  • Middle Aged
  • Mycoses* / diagnosis
  • Mycoses* / etiology
  • Patient Selection
  • Peritoneal Dialysis* / adverse effects
  • Peritoneal Dialysis* / methods
  • Peritonitis* / diagnosis
  • Peritonitis* / etiology
  • Peritonitis* / microbiology
  • Renal Insufficiency, Chronic / microbiology
  • Renal Insufficiency, Chronic / therapy
  • Rhodococcus / isolation & purification*

Substances

  • Biomarkers
  • Mannans
  • galactomannan
  • Galactose