Skip to main content

Advertisement

SpringerLink
Log in

Significance of Isolated Positive IgM Serologic Results by Enzyme Immunoassay for Coccidioidomycosis

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Serologic testing is important for diagnosis of coccidioidomycosis. Many methods are available for diagnostic testing. Enzyme immunoassay (EIA) can be performed quickly and locally but has the potential for false-positive results in patients manifesting a positive EIA for immunoglobulin M (IgM) antibodies and a negative EIA for immunoglobulin G (IgG). We retrospectively reviewed the charts of 405 patients with coccidioidal serologic testing performed between 1999 and 2003. Of 706 EIAs, 37 (5%) produced test results for 28 patients that showed isolated IgM positivity. Among these 28 patients, 24 (86%) had positive serologic findings by other methods (complement fixation or immunodiffusion or both), and 7 (25%) had positive microbiologic or histopathologic findings. All 4 (14%) patients without other positive serologic results had diagnostic tests with positive microbiologic or histopathologic results. No false-positive IgM assays were observed. We conclude that the false-positive rate of the EIA IgM is low, and that an isolated positive EIA IgM should prompt further follow-up and diagnostic testing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

ADHS:

Arizona Department of Health Services

CF:

Complement fixation

EIA:

Enzyme immunoassay

HIV:

Human immunodeficiency virus

ID:

Immunodiffusion

IgG:

Immunoglobulin G

IgM:

Immunoglobulin M

References

  1. Crum NF, Lederman ER, Stafford CM, Parrish JS, Wallace MR. Coccidioidomycosis: a descriptive survey of a reemerging disease: clinical characteristics and current controversies. Medicine (Baltimore). 2004;83:149–75.

    Article  Google Scholar 

  2. Chiller TM, Galgiani JN, Stevens DA. Coccidioidomycosis. Infect Dis Clin North Am. 2003;17:41–57.

    Article  PubMed  Google Scholar 

  3. Anstead GM, Graybill JR. Coccidioidomycosis. Infect Dis Clin North Am. 2006;20:621–43.

    Article  PubMed  Google Scholar 

  4. Pappagianis D, Zimmer BL. Serology of coccidioidomycosis. Clin Microbiol Rev. 1990;3:247–68.

    PubMed  CAS  Google Scholar 

  5. Blair JE, Coakley B, Santelli AC, Hentz JG, Wengenack NL. Serologic testing for symptomatic coccidioidomycosis in immunocompetent and immunosuppressed hosts. Mycopathologia. 2006;162:317–24.

    Article  PubMed  Google Scholar 

  6. Wieden MA, Lundergan LL, Blum J, Delgado KL, Coolbaugh R, Howard R, et al. Detection of coccidioidal antibodies by 33-kDa spherule antigen, Coccidioides EIA, and standard serologic tests in sera from patients evaluated for coccidioidomycosis. J Infect Dis. 1996;173:1273–7.

    PubMed  CAS  Google Scholar 

  7. Kaufman L, Sekhon AS, Moledina N, Jalbert M, Pappagianis D. Comparative evaluation of commercial Premier EIA and microimmunodiffusion and complement fixation tests for Coccidioides immitis antibodies. J Clin Microbiol. 1995;33:618–9.

    PubMed  CAS  Google Scholar 

  8. International classification of diseases, 9th revision, clinical modification: Med-Index ICD-9-CM. 4th ed. Salt Lake City (UT): Med-Index; 1994.

  9. Palmer DF, Kaufman L, Kaplan W, Cavallaro JJ, editors. Serodiagnosis of mycotic diseases. Springfield (IL): Charles C Thomas; 1977.

  10. Kuberski T, Myers R, Wheat LJ, Durkin M, Connolly P, Kubak BM, et al. Diagnosis of coccidioidomycosis by antigen detection using cross-reaction with a Histoplasma antigen. Clin Infect Dis. 2007;44:e50–4.

    Article  PubMed  Google Scholar 

  11. Saubolle MA, McKellar PP, Sussland D. Epidemiologic, clinical, and diagnostic aspects of coccidioidomycosis. J Clin Microbiol. 2007;45:26–30.

    Article  PubMed  CAS  Google Scholar 

  12. Martins TB, Jaskowski TD, Mouritsen CL, Hill HR. Comparison of commercially available enzyme immunoassay with traditional serological tests for detection of antibodies to Coccidioides immitis. J Clin Microbiol. 1995;33:940–3.

    PubMed  CAS  Google Scholar 

  13. Pappagianis D. Serologic studies in coccidioidomycosis. Semin Respir Infect 2001;16:242–50.

    Article  PubMed  CAS  Google Scholar 

  14. Smith CE, Saito MT, Beard RR, Kepp RM, Clark RW, Eddie BU. Serological tests in the diagnosis and prognosis of coccidioidomycosis. Am J Hyg. 1950;52:1–21.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, 85259, USA

    Janis E. Blair

  2. Northern Arizona University, Flagstaff, AZ, USA

    Jeremiah T. Currier

Authors
  1. Janis E. Blair
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeremiah T. Currier
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

J. T. Currier was a Visiting Research Trainee at the Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blair, J.E., Currier, J.T. Significance of Isolated Positive IgM Serologic Results by Enzyme Immunoassay for Coccidioidomycosis. Mycopathologia 166, 77–82 (2008). https://doi.org/10.1007/s11046-008-9129-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-008-9129-9

Keywords

Search

Navigation