山口医学

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山口医学 Volume 40 Issue 3
published_at 1991-06

Laboratory diagnosis of deep-seated fungal infection : 1. diagnosis significance of urine, soutum and stool cultures and microscopic observation on yeasts in urinary sediment

深在性真菌症の検査医学的診断(I) : 尿、喀痰および便培養検査ならびに尿沈渣中酵母の鏡検の意義
Matsuo Shuji
Descriptions
The significance of urine, sputum and stool cultures and microscopic obserbation on yeasts in urinary semiment for the diagnosis of deep-seated fungal infections was evaluated. On a reviea of 1651 autopsied cases including 240 cases with histological evidence of fungal infection and 101 non-infected cases with hematological disorders, the author proposed the diagnostic critera. Urine and stool sultures allowed the diagnosis of candidiasis of the urinary tract and the digestive tract, respectively, and a cut-off value of ≧10^4 cfu/ml in urine culture (sensitivity 63%, specificity 90%) and ≧10^6 cfu/ml in stool culture (sensitivity 30%, soecificity 100%) were considered to be appropriate for the diagnostic sritera. Many yeasts (≧200/x400 field) or the constant presence of yeasts in urinary sediments of repeated urinalysis was another useful sritetion for the diagnosis of urinary tract candidiasis (sensitivity 67%, specificity 86%). Sputum sulture allowed the diagnosis of respiratory aspergillosis and candidiasis. Repeaatedly positice results (sensitivity 35%, specificity 100%) and a singlr result of ≧10^5 cfu/ml (sensitivity 22%, specificity 100%) were useful criteria for diagnosis of the respective diseases.