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BioMed Research International
Volume 2013, Article ID 698325, 8 pages
http://dx.doi.org/10.1155/2013/698325
Review Article

Evaluation of Human Body Fluids for the Diagnosis of Fungal Infections

Alborzi Clinical Microbiology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Zand Avenue, Shiraz 7193711351, Iran

Received 18 March 2013; Revised 9 July 2013; Accepted 18 July 2013

Academic Editor: Visith Thongboonkerd

Copyright © 2013 Parisa Badiee. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. C. Fourtounas, M. Marangos, P. Kalliakmani, E. Savidaki, D. S. Goumenos, and J. G. Vlachojannis, “Treatment of peritoneal dialysis related fungal peritonitis with caspofungin plus amphotericin B combination therapy,” Nephrology Dialysis Transplantation, vol. 21, no. 1, pp. 236–237, 2006. View at Publisher · View at Google Scholar · View at Scopus
  2. P. Badiee and A. Alborzi, “Susceptibility of clinical Candida species isolates to antifungal agents by E-test, Southern Iran: a five year study,” Iranian Journal of Microbiology, vol. 3, no. 4, pp. 183–188, 2011. View at Google Scholar · View at Scopus
  3. S. C. Predari, A. N. De Paulis, D. Verón, A. Zucchini, and J. E. Santoianni, “Fungal peritonitis in patients on peritoneal dialysis: twenty five years of experience in a teaching hospital in Argentina,” Revista Argentina de Microbiologia, vol. 39, no. 4, pp. 213–217, 2007. View at Google Scholar · View at Scopus
  4. K. E. Black and L. R. Baden, “Fungal infections of the CNS: treatment strategies for the immunocompromised patient,” CNS Drugs, vol. 21, no. 4, pp. 293–318, 2007. View at Publisher · View at Google Scholar · View at Scopus
  5. A. Chakrabarti, “Epidemiology of central nervous system mycoses,” Neurology India, vol. 55, no. 3, pp. 191–197, 2007. View at Google Scholar · View at Scopus
  6. J. M. K. Murthy, “Fungal infections of the central nervous system: the clinical syndromes,” Neurology India, vol. 55, no. 3, pp. 221–225, 2007. View at Google Scholar · View at Scopus
  7. P. Badiee, A. Alborzi, and M. Joukar, “Molecular assay to detect nosocomial fungal infections in intensive care units,” European Journal of Internal Medicine, vol. 22, no. 6, pp. 611–615, 2011. View at Publisher · View at Google Scholar · View at Scopus
  8. C.-J. Huang, H. A. Pitt, P. A. Lipsett et al., “Pyogenic hepatic abscess: changing trends over 42 years,” Annals of Surgery, vol. 223, no. 5, pp. 600–609, 1996. View at Publisher · View at Google Scholar · View at Scopus
  9. G. J. Wise, G. S. Talluri, and V. K. Marella, “Fungal infections of the genitourinary system: manifestations, diagnosis, and treatment,” Urologic Clinics of North America, vol. 26, no. 4, pp. 701–718, 1999. View at Publisher · View at Google Scholar · View at Scopus
  10. T. L. Pruett, O. D. Rotstein, J. Grass, M. P. Frick, A. Flohr, and R. L. Simmons, “Percutaneous aspiration and drainage for suspected abdominal infection,” Surgery, vol. 96, no. 4, pp. 731–737, 1984. View at Google Scholar · View at Scopus
  11. B. De Pauw, T. J. Walsh, J. P. Donnelly et al., “Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group,” Clinical Infectious Diseases, vol. 46, no. 12, pp. 1813–1821, 2008. View at Publisher · View at Google Scholar · View at Scopus
  12. S.-C. Ko, K.-Y. Chen, P.-R. Hsueh, K.-T. Luh, and P.-C. Yang, “Fungal empyema thoracis: an emerging clinical entity,” Chest, vol. 117, no. 6, pp. 1672–1678, 2000. View at Google Scholar · View at Scopus
  13. E. Hollenbach, “To treat or not to treat—critically ill patients with candiduria,” Mycoses, vol. 51, no. 2, pp. 12–24, 2008. View at Publisher · View at Google Scholar · View at Scopus
  14. Z. A. Bukhary, “Candiduria: a review of clinical significance and management,” Saudi Journal of Kidney Diseases and Transplantation, vol. 19, no. 3, pp. 350–360, 2008. View at Google Scholar · View at Scopus
  15. A. H. Limper, K. S. Knox, G. A. Sarosi et al., “An official American Thoracic Society statement: treatment of fungal infections in adult pulmonary and critical care patients,” American Journal of Respiratory and Critical Care Medicine, vol. 183, no. 1, pp. 96–128, 2011. View at Publisher · View at Google Scholar · View at Scopus
  16. P. Montravers, H. Dupont, R. Gauzit et al., “Candida as a risk factor for mortality in peritonitis,” Critical Care Medicine, vol. 34, no. 3, pp. 646–652, 2006. View at Publisher · View at Google Scholar · View at Scopus
  17. P. Badiee, A. Alborzi, M. Moeini, and P. Haddadi, “Antifungal susceptibility of the Aspergillus species by Etest and CLSI Reference Methods,” Archives of Iranian Medicine, vol. 15, no. 7, pp. 429–432, 2012. View at Google Scholar
  18. K.-Y. Chen, S.-C. Ko, P.-R. Hsueh, K.-T. Luh, and P.-C. Yang, “Pulmonary fungal infection: emphasis on microbiological spectra, patient outcome, and prognostic factors,” Chest, vol. 120, no. 1, pp. 177–184, 2001. View at Publisher · View at Google Scholar · View at Scopus
  19. M. El-Ebiary, A. Torres, N. Fàbregas et al., “Significance of the isolation of Candida species from respiratory samples in critically ill, non-neutropenic patients: an immediate postmortem histologic study,” American Journal of Respiratory and Critical Care Medicine, vol. 156, no. 2, pp. 583–590, 1997. View at Google Scholar · View at Scopus
  20. M. Kimura, S.-I. Udagawa, K. Makimura, K. Satoh, N. Toyazaki, and H. Ito, “Isolation and identification of Rhizomucor pusillus from pleural zygomycosis in an immunocompetent patient,” Medical Mycology, vol. 47, no. 8, pp. 869–873, 2009. View at Publisher · View at Google Scholar · View at Scopus
  21. L. S. Guazzelli, C. B. Severo, L. S. Hoff, G. L. F. Pinto, J. J. Camargo, and L. C. Severo, “Aspergillus fumigatus fungus ball in the pleural cavity,” Jornal Brasileiro de Pneumologia, vol. 38, no. 1, pp. 125–132, 2012. View at Publisher · View at Google Scholar · View at Scopus
  22. M. A. Sackner, A. Wanner, and J. Landa, “Applications of bronchofiberoscopy,” Chest, vol. 62, supplement 5, pp. 70–78, 1972. View at Google Scholar · View at Scopus
  23. H. Y. Reynolds, “Immunologic system in the respiratory tract,” Physiological Reviews, vol. 71, no. 4, pp. 1117–1133, 1991. View at Google Scholar · View at Scopus
  24. J. Salonen, O.-P. Lehtonen, M.-R. Teräsjärvi, and J. Nikoskelainen, “Aspergillus antigen in serum, urine and bronchoalveolar lavage specimens of neutropenic patients in relation to clinical outcome,” Scandinavian Journal of Infectious Diseases, vol. 32, no. 5, pp. 485–490, 2000. View at Google Scholar · View at Scopus
  25. P. D. Khot, D. L. Ko, R. C. Hackman, and D. N. Fredricks, “Development and optimization of quantitative PCR for the diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid,” BMC Infectious Diseases, vol. 8, article 73, 2008. View at Publisher · View at Google Scholar · View at Scopus
  26. B. Musher, D. Fredricks, W. Leisenring, S. A. Balajee, C. Smith, and K. A. Marr, “Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid,” Journal of Clinical Microbiology, vol. 42, no. 12, pp. 5517–5522, 2004. View at Publisher · View at Google Scholar · View at Scopus
  27. P. V. Murray, M. E. R. O'Brien, A. R. Padhani et al., “Use of first line bronchoalveolar lavage in the immunosuppressed oncology patient,” Bone Marrow Transplantation, vol. 27, no. 9, pp. 967–971, 2001. View at Publisher · View at Google Scholar · View at Scopus
  28. T. I. Chang, H. W. Kim, J. T. Park et al., “Early catheter removal improves patient survival in peritoneal dialysis patients with fungal peritonitis: results of ninety-four episodes of fungal peritonitis at a single center,” Peritoneal Dialysis International, vol. 31, no. 1, pp. 60–66, 2011. View at Publisher · View at Google Scholar · View at Scopus
  29. P. G. Martos, F. G. de Sola, P. Marín et al., “Fungal peritonitis in continuous ambulatory peritoneal dialysis: a 10 cases description,” Nefrologia, vol. 29, no. 6, pp. 534–539, 2009. View at Publisher · View at Google Scholar · View at Scopus
  30. P. Montravers, R. Gauzit, C. Muller, J. P. Marmuse, A. Fichelle, and J. M. Desmonts, “Emergence of antibiotic-resistant bacteria in cases of peritonitis after intraabdominal surgery affects the efficacy of empirical antimicrobial therapy,” Clinical Infectious Diseases, vol. 23, no. 3, pp. 486–494, 1996. View at Google Scholar · View at Scopus
  31. A. Roehrborn, L. Thomas, O. Potreck et al., “The microbiology of postoperative peritonitis,” Clinical Infectious Diseases, vol. 33, no. 9, pp. 1513–1519, 2001. View at Publisher · View at Google Scholar · View at Scopus
  32. J. Matuszkiewicz-Rowinska, “Update on fungal peritonitis and its treatment,” Peritoneal Dialysis International, vol. 29, supplement 2, pp. S161–S165, 2009. View at Google Scholar · View at Scopus
  33. J. S. Solomkin, A. B. Flohr, P. G. Quie, and R. L. Simmons, “The role of Candida in intraperitoneal infections,” Surgery, vol. 88, no. 4, pp. 524–530, 1980. View at Google Scholar · View at Scopus
  34. H. Dupont, A. Bourichon, C. Paugam-Burtz, J. Mantz, and J.-M. Desmonts, “Can yeast isolation in peritoneal fluid be predicted in intensive care unit patients with peritonitis?” Critical Care Medicine, vol. 31, no. 3, pp. 752–757, 2003. View at Publisher · View at Google Scholar · View at Scopus
  35. Y.-S. Shan, H.-P. Hsu, Y.-H. Hsieh, E. D. Sy, J.-C. Lee, and P.-W. Lin, “Significance of intraoperative peritoneal culture of fungus in perforated peptic ulcer,” British Journal of Surgery, vol. 90, no. 10, pp. 1215–1219, 2003. View at Publisher · View at Google Scholar · View at Scopus
  36. J. F. Fisher, J. D. Sobel, C. A. Kauffman, and C. A. Newman, “Candida urinary tract infections—treatment,” Clinical Infectious Diseases, vol. 52, supplement 6, pp. S457–S466, 2011. View at Publisher · View at Google Scholar · View at Scopus
  37. C. A. Kauffman, J. A. Vazquez, J. D. Sobel et al., “Prospective multicenter surveillance study of funguria in hospitalized patients,” Clinical Infectious Diseases, vol. 30, no. 1, pp. 14–18, 2000. View at Publisher · View at Google Scholar · View at Scopus
  38. O. Ayeni, K. M. Riederer, F. M. Wilson, and R. Khatib, “Clinicians' reaction to positive urine culture for Candida organisms,” Mycoses, vol. 42, no. 4, pp. 285–289, 1999. View at Publisher · View at Google Scholar · View at Scopus
  39. S. P. Storfer, G. Medoff, V. J. Fraser, W. G. Powderly, and W. C. Dunagan, “Candiduria: retrospective review in hospitalized patients,” Infectious Diseases in Clinical Practice, vol. 3, no. 1, pp. 23–29, 1994. View at Google Scholar · View at Scopus
  40. J. D. Sobel, “Controversies in the diagnosis of candiduria: what is the critical colony count?” Current Treatment Options Infectious, vol. 4, pp. 81–83, 2002. View at Google Scholar
  41. E. D. Everett, T. C. Eickhofe, and J. M. Ehret, “Immunofluorescence of yeast in urine,” Journal of Clinical Microbiology, vol. 2, no. 2, pp. 142–143, 1975. View at Google Scholar · View at Scopus
  42. J. Schonebeck, “Studies on Candida infection of the urinary tract and on the antimycotic drug 5-fluorocytosine,” Scandinavian Journal of Urology and Nephrology, vol. 1, supplement 11, pp. 7–48, 1972. View at Google Scholar
  43. E. E. Navarro, J. S. Almario, C. King, J. Bacher, P. A. Pizzo, and T. J. Walsh, “Detection of Candida casts in experimental renal candidiasis: implications for the diagnosis and pathogenesis of upper urinary tract infection,” Journal of Medical and Veterinary Mycology, vol. 32, no. 6, pp. 415–426, 1994. View at Google Scholar · View at Scopus
  44. C. Argyle, G. B. Schumann, L. Genack, and M. Gregory, “Identification of fungal casts in a patient with renal candidiasis,” Human Pathology, vol. 15, no. 5, pp. 480–481, 1984. View at Google Scholar · View at Scopus
  45. S. A. Harding and W. G. Merz, “Evaluation of antibody coating of yeasts in urine as an indicator of the site of urinary tract infection,” Journal of Clinical Microbiology, vol. 2, no. 3, pp. 222–225, 1975. View at Google Scholar · View at Scopus
  46. W. J. Hall, “Study of antibody-coated fungi in patients with funguria and suspected disseminated fungal infections or primary fungal pyelonephritis,” Journal of the Royal Society of Medicine, vol. 73, no. 8, pp. 567–569, 1980. View at Google Scholar · View at Scopus
  47. J. F. Fisher, K. Kavanagh, J. D. Sobel, C. A. Kauffman, and C. A. Newman, “Candida urinary tract infection: pathogenesis,” Clinical Infectious Diseases, vol. 52, supplement 6, pp. S437–S451, 2011. View at Publisher · View at Google Scholar · View at Scopus
  48. C. A. Kauffman, “Candiduria: diagnostic and treatment conundrums,” Current Treatment Options Infectious Diseases, vol. 4, pp. 513–519, 2002. View at Google Scholar
  49. E. E. Navarro, J. S. Almario, R. L. Schaufele, J. Bacher, and T. J. Walsh, “Quantitative urine cultures do not reliably detect renal candidiasis in rabbits,” Journal of Clinical Microbiology, vol. 35, no. 12, pp. 3292–3297, 1997. View at Google Scholar · View at Scopus
  50. C. C. Canver, A. K. Patel, P. Kosolcharoen, and M. C. Voytovich, “Fungal purulent constrictive pericarditis in a heart transplant patient,” Annals of Thoracic Surgery, vol. 65, no. 6, pp. 1792–1794, 1998. View at Publisher · View at Google Scholar · View at Scopus
  51. R. Rabinovici, D. Szewczyk, P. Ovadia, J. R. Greenspan, and J. J. Sivalingam, “Candida pericarditis: clinical profile and treatment,” Annals of Thoracic Surgery, vol. 63, no. 4, pp. 1200–1204, 1997. View at Publisher · View at Google Scholar · View at Scopus
  52. M. B. Cishek, B. Yost, and S. Schaefer, “Cardiac aspergillosis presenting as myocardial infarction,” Clinical Cardiology, vol. 19, no. 10, pp. 824–827, 1996. View at Google Scholar · View at Scopus
  53. J. Wheat, “Histoplasmosis: experience during outbreaks in Indianapolis and review of the literature,” Medicine, vol. 76, no. 5, pp. 339–354, 1997. View at Publisher · View at Google Scholar · View at Scopus
  54. D. H. Spodick, The Pericardium: A Comprehensive Textbook, Marcel Dekker, New York, NY, USA, 1997.
  55. B. Maisch, P. M. Seferović, A. D. Ristić et al., “Guidelines on the diagnosis and management of pericardial diseases executive summary the task force on the diagnosis and management of pericardial diseases of the European society of cardiology,” European Heart Journal, vol. 25, no. 7, pp. 587–610, 2004. View at Publisher · View at Google Scholar · View at Scopus
  56. P. Badiee, A. Alborzi, E. Shakiba, M. Ziyaeyan, and B. Pourabbas, “Molecular diagnosis of Aspergillus endocarditis after cardiac surgery,” Journal of Medical Microbiology, vol. 58, no. 2, pp. 192–195, 2009. View at Publisher · View at Google Scholar · View at Scopus
  57. A. R. Kosmin and T. Fekete, “Use of fungal blood cultures in an Academic Medical Center,” Journal of Clinical Microbiology, vol. 46, no. 11, pp. 3800–3801, 2008. View at Publisher · View at Google Scholar · View at Scopus
  58. D. A. Stevens, V. L. Kan, M. A. Judson et al., “Practice guidelines for diseases caused by Aspergillus,” Clinical Infectious Diseases, vol. 30, no. 4, pp. 696–709, 2000. View at Publisher · View at Google Scholar · View at Scopus
  59. J. C. Varghese, P. F. Hahn, M. G. Harisinghani et al., “Fungus-infected fluid collections in thorax or abdomen: effectiveness of percutaneous catheter drainage,” Radiology, vol. 236, no. 2, pp. 730–738, 2005. View at Publisher · View at Google Scholar · View at Scopus
  60. M. E. Falagas, K. E. Apostolou, and V. D. Pappas, “Attributable mortality of candidemia: a systematic review of matched cohort and case-control studies,” European Journal of Clinical Microbiology & Infectious Diseases, vol. 25, no. 7, pp. 419–425, 2006. View at Publisher · View at Google Scholar · View at Scopus
  61. J. W. Pickering, H. W. Sant, C. A. P. Bowles, W. L. Roberts, and G. L. Woods, “Evaluation of a (1→3)-β-D-glucan assay for diagnosis of invasive fungal infections,” Journal of Clinical Microbiology, vol. 43, no. 12, pp. 5957–5962, 2005. View at Publisher · View at Google Scholar · View at Scopus
  62. L. Ostrosky-Zeichner, B. D. Alexander, D. H. Kett et al., “Multicenter clinical evaluation of the (1→3) β-D-glucan assay as an aid to diagnosis of fungal infections in humans,” Clinical Infectious Diseases, vol. 41, no. 5, pp. 654–659, 2005. View at Publisher · View at Google Scholar · View at Scopus
  63. C. Viscoli, M. Machetti, P. Gazzola et al., “Aspergillus galactomannan antigen in the cerebrospinal fluid of bone marrow transplant recipients with probable cerebral aspergillosis,” Journal of Clinical Microbiology, vol. 40, no. 4, pp. 1496–1499, 2002. View at Publisher · View at Google Scholar · View at Scopus
  64. D. Rimek, K. Redetzke, J. Singh, K. Heinrich, and R. Kappe, “Performance of the Candida mannan antigen detection in patients with fungemia,” Mycoses, vol. 47, no. 1, pp. 23–26, 2004. View at Google Scholar · View at Scopus
  65. H. Yera, B. Sendid, N. Francois, D. Camus, and D. Poulain, “Contribution of serological tests and blood culture to the early diagnosis of systemic candidiasis,” European Journal of Clinical Microbiology & Infectious Diseases, vol. 20, no. 12, pp. 864–870, 2001. View at Publisher · View at Google Scholar · View at Scopus
  66. P. Badiee, P. Kordbacheh, A. Alborzi, and S. A. Malekhoseini, “Invasive fungal infection in renal transplant recipients demonstrated by panfungal polymerase chain reaction,” Experimental and Clinical Transplantation, vol. 5, no. 1, pp. 624–629, 2007. View at Google Scholar · View at Scopus
  67. C. Lass-Flörl, E. Gunsilius, G. Gastl et al., “Diagnosing invasive aspergillosis during antifungal therapy by PCR analysis of blood samples,” Journal of Clinical Microbiology, vol. 42, no. 9, pp. 4154–4157, 2004. View at Publisher · View at Google Scholar · View at Scopus
  68. A. J. M. Van Deventer, W. H. F. Goessens, A. Van Belkum, E. W. M. Van Etten, H. J. A. Van Vliet, and H. A. Verbrugh, “PCR monitoring of response to liposomal amphotericin B treatment of systemic candidiasis in neutropenic mice,” Journal of Clinical Microbiology, vol. 34, no. 1, pp. 25–28, 1996. View at Google Scholar · View at Scopus
  69. P. Badiee, P. Kordbacheh, A. Alborzi et al., “Study on invasive fungal infections in immunocompromised patients to present a suitable early diagnostic procedure,” International Journal of Infectious Diseases, vol. 13, no. 1, pp. 97–102, 2009. View at Publisher · View at Google Scholar · View at Scopus
  70. P. Badiee and A. Alborzi, “Detection of Aspergillus species in bone marrow transplant patients,” Journal of Infection in Developing Countries, vol. 4, no. 8, pp. 511–516, 2010. View at Google Scholar · View at Scopus
  71. P. Badiee, A. Alborzi, R. Vojdani et al., “Early diagnosis of systemic candidiasis in bone marrow transplant recipients,” Experimental and Clinical Transplantation, vol. 8, no. 2, pp. 98–103, 2010. View at Google Scholar · View at Scopus
  72. A. C. Pettit, J. A. Kropski, J. L. Castilho et al., “The index case for the fungal meningitis outbreak in the United States,” The New England Journal of Medicine, vol. 367, no. 22, pp. 2119–2125, 2012. View at Google Scholar
  73. D. L. Pagano, C. Girmenia, L. Mele et al., “Infections caused by filamentous fungi in patients with hematologic malignancies. A report of 391 cases by GINEMA infection program,” Haematologica, vol. 86, no. 8, pp. 862–870, 2001. View at Google Scholar · View at Scopus
  74. D. A. Jerrard, J. R. Hanna, and G. L. Schindelheim, “Cerebrospinal fluid,” Journal of Emergency Medicine, vol. 21, no. 2, pp. 171–178, 2001. View at Publisher · View at Google Scholar · View at Scopus
  75. J. Davis, D. Costello, and N. Venna, “Laboratory investigation of fungal infections of the central nervous system,” Neurology India, vol. 55, no. 3, pp. 233–240, 2007. View at Google Scholar · View at Scopus
  76. C. S. F. Purulent, “Cerebrospinal fluid analysis,” American Familiar Physician, vol. 68, no. 6, pp. 1103–1109, 2003. View at Google Scholar
  77. R. K. Khurana, “Intracranial Hypotension,” Seminars in Neurology, vol. 16, no. 1, pp. 5–10, 1996. View at Google Scholar · View at Scopus
  78. P. Badiee and A. Alborzi, “Assessment of a real-time PCR method to detect human non-cryptococcal fungal meningitis,” Archives of Iranian Medicine, vol. 14, no. 6, pp. 381–384, 2011. View at Google Scholar · View at Scopus
  79. R. Golmia, I. Bello, A. Marra, N. Hamerschlak, A. Osawa, and M. Scheinberg, “Aspergillus fumigatus joint infection: a review,” Seminars in Arthritis and Rheumatism, vol. 40, no. 6, pp. 580–584, 2011. View at Publisher · View at Google Scholar · View at Scopus
  80. B. H. Hwang, J. Y. Yoon, C. H. Nam et al., “Fungal peri-prosthetic joint infection after primary total knee replacement,” British Journal of Bone & Joint Surgery, vol. 94, no. 5, pp. 656–659, 2012. View at Google Scholar
  81. J. Merrer, B. Dupont, A. Nieszkowska, B. De Jonghe, and H. Outin, “Candida albicans prosthetic arthritis treated with fluconazole alone,” Journal of Infection, vol. 42, no. 3, pp. 208–209, 2001. View at Publisher · View at Google Scholar · View at Scopus
  82. T. K. Fábián, P. Hermann, A. Beck, P. Fejérdy, and G. Fábián, “Salivary defense proteins: their network and role in innate and acquired oral immunity,” International Journal of Molecular Sciences, vol. 13, no. 4, pp. 4295–4320, 2012. View at Google Scholar
  83. S. R. Torres, A. GarzinoDemo, T. F. Meiller, V. Meeks, and M. A. Jabra-Rizk, “Salivary histatin-5 and oral fungal colonisation in HIV+ individuals,” Mycoses, vol. 52, no. 1, pp. 11–15, 2009. View at Google Scholar
  84. M. Navazesh, G. J. Wood, and V. J. Brightman, “Relationship between salivary flow rates and Candida albicans counts,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 80, no. 3, pp. 284–288, 1995. View at Google Scholar · View at Scopus
  85. S. Fischer, V. J. Gill, J. Kovacs et al., “The use of oral washes to diagnose Pneumocystis carinii pneumonia: a blinded prospective study using a polymerase chain reaction-based detection system,” The Journal of Infectious Diseases, vol. 184, no. 11, pp. 1485–1488, 2001. View at Publisher · View at Google Scholar · View at Scopus