"False negative" CSF cryptococcal antigen with clinical meningitis: Case reports and review of literature

Morris K Rutakingirwa; Tadeo K Kiiza; Joshua Rhein

doi:10.1016/j.mmcr.2020.06.003

"False negative" CSF cryptococcal antigen with clinical meningitis: Case reports and review of literature

Med Mycol Case Rep. 2020 Jun 11:29:29-31. doi: 10.1016/j.mmcr.2020.06.003. eCollection 2020 Sep.

Authors

Morris K Rutakingirwa¹, Tadeo K Kiiza¹, Joshua Rhein^{1

2}

Affiliations

¹ Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala, Uganda.
² University of Minnesota, Minneapolis, MN, 55455, USA.

Abstract

There is an increasing recognition of patients presenting with cryptococcal meningitis despite having a negative CSF cryptococcal antigen (CrAg). In this report, we describe three cases of patients with advanced immunosuppression who presented to hospital with "false negative" CSF cryptococcal antigen, two of whom had a positive fungal culture. We describe the challenge of CSF-CrAg negative cryptococcal meningitis and explore ways to overcome this challenge using newer diagnostic techniques.

Keywords: Cryptococcal meningitis; Cryptococcosis; HIV; Lateral flow assay; Prozone effect.

Grants and funding

MR/M007413/1/MRC_/Medical Research Council/United Kingdom