Diagnosis of invasive candidiasis in patients with and without signs of immune deficiency: a comparison of six detection methods in human serum

Visceral candidiasis in 56 patients, 39 of whom were thought to be immune deficient, was investigated using three serological detection methods--whole cell agglutination, haemagglutination, and counterimmunoelectrophoresis for antibodies; two determinations of circulating antigens--haemagglutination inhibition and latex agglutination; and determination of the arabinitol:creatinine ratio. Of the 39 patients with suspected immune deficiency, 13 had confirmed invasive candidiasis and 26 were colonised; of those without signs of immune deficiency, 10 patients also had invasive candidiasis and seven were colonised. Twenty three patients with invasive candidiasis were analysed in total. For suspected immune deficient patients the best discrimination between visceral candidiasis and colonisation was obtained by combining the results of haemagglutination inhibition and arabinitol:creatinine ratio. For patients without signs of immune deficiency the best discrimination between invasive candidiasis and colonisation was achieved with counterimmunoelectrophoresis. The results of the serological tests confirmed the classification on clinical grounds of those with and without immune deficiency.