AccScience Publishing / ITPS / Online First / DOI: 10.36922/itps.4528
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Evaluation of galactomannan and 1,3-β-d-glucan assays as diagnostic tools for intracranial fungal infection: A case series

Suneel Kumar1 ,  Zuhaa Rehman1* ,  Anabia Akhlaq1 ,  Taha Bin Ajaz Khan1 ,  Naeemullah Bullo1 ,  Munir Afzal1
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1 Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan
INNOSC Theranostics and Pharmacological Sciences, 4528 https://doi.org/10.36922/itps.4528
Submitted: 15 August 2024 | Revised: 10 November 2024 | Accepted: 11 December 2024 | Published: 3 January 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Fungal infections of the central nervous system have dramatically surged over the past decade, particularly in semitropical regions such as Karachi. Herein, we retrospectively evaluated the diagnostic potential of galactomannan (GM) and 1,3-β-d-glucan (BDG) assays for intracranial fungal infections (IFI) at a tertiary care facility in Karachi. A total of 12 patients (3 immunocompromised and 9 immunocompetent) aged 18 – 60 years underwent serum fungal biomarker testing, imaging studies, and cerebrospinal fluid (CSF) analysis. Suboptimal GM and high BDG titers indicated invasive mycoses. Computed tomography scan revealed fungal sinusitis, and magnetic resonance imaging revealed brain parenchyma involvement. Fungal biomarkers helped rule out a neoplastic etiology. Normal GM and high BDG titers negated the probability of aspergillosis. Further, culture tests helped identify the causative organisms and tailor the treatment. Our findings emphasize the diagnostic value of GM and BDG assays in IFIs. Furthermore, we recommend the use of CSF specimens for fungal biomarker assays in future diagnostic protocols.

Keywords
Intracranial fungal infection
Galactomannan
Fungal sinusitis
d-glucan
1-3-β-d-glucan
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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INNOSC Theranostics and Pharmacological Sciences, Electronic ISSN: 2705-0823 Print ISSN: 2705-0734, Published by AccScience Publishing
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