Clinics and Departments

Laboratory Services

Lab Dept:

Serology

Test Name:

COCCIDIOIDES ANTIBODY, CSF

General Information

Lab Order Codes:

CABS

Synonyms:

Cocci CF and ID, CSF; Coccidioides Antibody, Spinal Fluid; San Joaquin Valley Fever

CPT Codes:

86635 x3 – Antibody; Coccidiodes

Test Includes:

Complement fixation and immunodiffusion coccidioides testing

Logistics

Test Indications:

Serologic testing for coccidioidomycosis should be considered when patients exhibit symptoms of meningeal infection and have lived or traveled in areas where Coccidioides immitis is endemic. Any history of exposure to the organism or travel cannot be overemphasized when coccidioidomycosis serologic tests are being considered.

Lab Testing Sections:

Serology - Sendouts

Referred to:

Mayo Medical Laboratories (Test# 81542)

Phone Numbers:

Minneapolis:

Saint Paul:

 

612-813-6280

651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

3 – 7 days; test set up on Monday - Friday

Special Instructions:

N/A

Specimen

Specimen Type:

CSF

Container:

Screw capped, plastic vial

Draw Volume:

2.0 mL (Minimum: 1.2 mL) spinal fluid

Processed Volume:

Same as Draw Volume

Collection:

Routine CSF collection

Special Processing:

Lab Staff: Store specimen in a screw-capped, round-bottom, plastic vial refrigerated. Send specimen refrigerated. Forward promptly.

Patient Preparation:

None

Sample Rejection:

Specimens other than CSF, hemolyzed specimens, mislabeled or unlabeled specimens

Interpretive

Reference Range:

Complement Fixation (CF):

Negative

If positive, results are titered

Any CF titer in CSF should be considered significant. A positive complement fixation test in unconcentrated cerebrospinal fluid is diagnostic of meningitis.

Immunodiffusion:

Negative

Results are reported as positive, negative or equivocal.

IgM and IgG precipitins are rarely found in CSF. However, when present, they are diagnostic of meningitis (100%) specific). Since the immunodiffusion test is 100% specific, it is helpful in interpreting Complement Fixation results.

Early primary antibody (IgM) found in coccidioidomycosis can be detected by the IgM-specific Immunodiffusion test. IgM precipitins may be detectable within 1-4 weeks after the onset of symptoms. The presence of IgG antibody parallels the Complement Fixation antibody and indicates an active of a recent asymptomatic infection with Coccidioides immitis. Both IgG and IgM antibodies are rarely detected 6 months after infection. However, in some patients having disseminated infection both IgG and IgM antibodies may be present for several years. IgM and IgG precipitins are not prognostic.

An equivocal result (a band of non-identity) cannot be interpreted as significant for a specific diagnosis. However, this may be an indication that a patient should be followed serologically.

The sensitivity of serologic testing (Complement Fixation and Immunodiffusion combined) for coccidioidomycosis is >90% for primary symptomatic cases.

Critical Values:

N/A

Limitations:

While Complement fixation (CF) titers may be present in serum months after the infection has resolved, any CF titer in CSF should be considered significant.

Methodology:

Complement Fixation (CF) using Coccidioidin
Immunodiffusion for IgG/IgM

Contraindications:

N/A

References:

Mayo Medical Laboratories Web Page February 2007



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