Clinical Features of Deep Mycosis in Critical Care Center-Comparison of Serological Tests and Cultures for Mycosis-

Abstract

The clincal features of invasive deep mycosis in the critical care center was studied and the usefulness for determinations of plasma (1-3)-β-D-glucan, one of the major structural components of fungi, in making the diagnosis of deep mycosis was evaluated in comparison with that of blood culture and candida antigen titer using CAND-tec kit. A total of 92 febrile patients (mean age=54.5yr., M/F=70/22) in our critical care center were enrolled in this study.
Seventeen out of the 92 febrile patients (18.5%) were those with deep mycosis. In the deep mycosis group, there were 10 patients with fungal panperitonitis, 5 with fungaemia, one with candidal pneumonia and one with candidal empyema.
A total of 52 blood samples were obtained from 17 patients with deep mycosis. Forty five out of the 52 blood samples (86.5%) were positive for serum (1-3)-β-D-glucan while only 10 were culturepositive. In contrast, six (15.0%) out of the 40 blood samples were obtaind from 17 patients with deep mycosis were positive for candida antigen by CAND-tec kit.
In the critical care center, deep mycosis is a common infection and determination of serum concentration of (1-3)-β-D-glucan is found to be a very useful examination in screening of deep mycosis with high sensitivity and specificity.