An immunocompromised patient from the Mississippi river valley presents with fever, weight loss, and hepatosplenomegaly. Which non-invasive diagnostic test has the highest sensitivity for disseminated Histoplasma capsulatum infection?
- A Urinary Histoplasma antigen ✓
- B Serum beta-D-glucan
- C Serum galactomannan
- D Blood culture on Lowenstein-Jensen medium
Correct answer: A. Urinary Histoplasma antigen
Explanation
Urinary Histoplasma antigen is highly sensitive for disseminated histoplasmosis. Serum galactomannan is specific for Aspergillus. Beta-D-glucan is positive but less specific. Blood culture on LJ is for mycobacteria; Sabouraud agar is used for fungi like Histoplasma.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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