Evaluation of different methods for rapid diagnosis of cryptococcal meningitis patients at tertiary care hospital

The rising incidence of cryptococcosis in India is posing a serious threat. Due to lack of sensitive methods for diagnosis, high morbidity and mortality are associated with the disease. Early diagnosis is essential to prevent serious complications. Therefore, we attempted to find highly sensitive and specific detection methods. A comparative evaluation of the detection of cryptococcosis was done by conventional (direct microscopy and culture) and rapid diagnosis by Latex agglutination test (LAT), cryptococcal antigen (CrAg) lateral flow immunochromatographic assay (LFA), we assessed diagnostic performance of cerebrospinal fluid (CSF) culture, CrAg latex agglutination, India ink microscopy, and CrAg LFA for 30 samples with suspected cryptococcal meningitis during the study period. CrAg LFA had the best performance (sensitivity 100%, Specificity 80%) for CSF, Serum as well as urine samples. India ink Microscopy was 66.7% sensitive. CrAg Lateral Flow Assay (LFA) is a simple, rapid and sensitive test for the early detection of cryptococcal antigen in clinical samples like CSF, Serum and urine and may be considered as an aid in establishing diagnosis when culture is positive/negative. CrAg LFA could be a major advance diagnostic approach in urine samples as non-invasive technique for Cryptococcal meningitis in resource limited setting.