Progressive disseminated histoplasmosis : a systematic review on the performance of non-culture-based diagnostic tests

Abstract

The diagnosis of progressive disseminated histoplasmosis is often a challenge to clinicians,especially due to the low sensitivity and long turnaround time of the classic diagnostic meth-ods. In recent years, studies involving a variety of non-culture-based diagnostic tests havebeen published in the literature. We performed a systematic review by selecting studies eval-uating non-culture-based diagnostic methods for progressive disseminated histoplasmosis.We searched for articles evaluating detection of antibody, antigens, as well as DNA-baseddiagnostic methods. A comprehensive PUBMED, Web of Science, and Cochrane Librarysearch was performed between the years 1956 and 2016. Case reports, review articles, non-human models and series involving less than 10 patients were excluded. We found 278articles and after initial review 18 articles were included: (12) involved antigen detectionmethods, (4) molecular methods, and (2) antibody detection methods. Here we demonstratethat the pursuit of new technologies is ultimately required for the early and accurate diag-nosis of disseminated histoplasmosis. In particular, urinary antigen detection was the mostaccurate tool when compared with other diagnostic techniques.