(1-3)-β-D-glucan in cerebrospinal fluid is useful for the diagnosis of central nervous system fungal infections.

TO THE EDITOR—A definitive diagnosis of invasive fungal infection (IFI) remains difficult in immunocompromised hosts. Thus, fungal markers such as galacto-mannan (GM) or (1-3)-β-D-glucan (BG) are useful for the diagnosis of probable IFI in high risk patients [1]. Detection of GM in cerebrospinal fluid (CSF) has been studied and is now considered diagnostic for central nervous system (CNS) aspergillosis in high-risk patients with a compatible neurological disease [1, 2]. Serum BG, major constituent of fungi other than the Mucorales, is being used for noninvasive diagnosis of fungal infection , and has been included as micro-biological criterion for the diagnosis of probable IFI in the revised definitions of IFI of the European Organization for the Research and Treatment of Cancer/ Mycoses Study Group (EORTC/MSG) [1]. BG has been widely studied in serum, but only 1 animal study has analyzed its levels in CSF in a