Calas

This study was conducted at Bordeaux University Hospital including every patient with positive cerebrospinal fluid (CSF) cryptococcal antigen testing, India ink preparation, and/or culture from January 2015 to December 2020.
Cerebrospinal fluid cryptococcal antigen testing was performed using CryptoPS test (BIOSYNEX®) and blood cryptococcal antigen testing using CALAS® (Meridian Bioscience). CSF samples were processed with India ink preparation and incubated on Sabouraud Agar + Chloramphenicol + Gentamicin media (Bio-Rad). Blood samples were incubated on BACT/ALERT® FA (bioMérieux) culture bottles. Identification of growing isolates was performed using MALDI-TOF mass spectrometry (Microflex®, Bruker Daltonics).
Diagnosis of sarcoidosis was retrospectively confirmed according to the current recommendations (35 (link)): (i) clinical and paraclinical features consistent with sarcoidosis, (ii) an histopathological analysis revealing non-caseating granuloma except for patients presenting Löfgren's syndrome, and (iii) exclusion of other possible etiologies, including other granulomatous disorders. Data were retrospectively collected from the electronic medical records, and the electronic worksheet was completed by two medical intensive care residents.

Serum samples from 58 koalas were collected by veterinarians at the three facilities by cephalic venipuncture with the koalas gently restrained. Samples were collected at various time points between December 2014 and August 2018 as part of the ongoing disease investigation and surveillance program and submitted to VPDS. All samples underwent cryptococcal antigen testing using an LFA (CrAg LFA; IMMY, Norman, OK, USA). If the LFA was positive, an LCAT (CALAS; Meridian Bioscience, Inc., Cincinnati, OH, USA) was performed to confirm the result and establish a reciprocal antigen titer (36 (link)). Both procedures were performed according to the manufacturers’ instructions by experienced staff and in the same laboratory.