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

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.