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IgM and IgG antibodies to Coccidioides antigen usually appear during the first month of infection and decline over the next 3-6 months but remain detectable for approximately 18-24 months in some cases with self-limited illnesses. Antibodies may persist in patients with chronic pulmonary complications or progressive extrapulmonary (disseminated) coccidioidomycosis. Antibodies may be falsely negative in some progressive or chronic cases. Follow-up testing may be considered at weeks 2-4 to determine if antibody levels are increasing, especially in patients with low positive results. An increase in antibody concentration would suggest recent infection. Antibodies may also be detected in healthy subjects who are asymptomatic as a result of sub-clinical infection within the last 18-36 months.
During validation testing, the combined sensitivity was found to be 92.00% and specificity 94.00% with an assay cutoff of 1.0 EU. It offers an improvement over the current method of detecting antibodies by FID, where sensitivity has been reported as only 32%. Complement fixation is even less sensitive than FID.
Semi-Quantitative Indirect Enzyme Immunoassay (EIA)
Specimens positive for Aspergillus spp., Histoplasma capsulatum, Paracoccidioides brasiliensis, or Talaromyces marneffei may cross-react with the Coccidioides Antibody EIA (IgG and IgM detection) and test positive.
A variety of interfering substances were investigated (hemoglobin/blood, total cholesterol, triglycerides, glucose, bilirubin, total protein, fluconazole, itraconazole, amphotericin B, voriconazole, vancomycin, piperacillin, tazobactam, ceftriaxone, tobramycin) and none affected the Coccidioides Antibody EIA sensitivity or specificity.
Serum: Collect serum specimens into a serum separator or red top tube. Allow blood to clot for 30 minutes, then centrifuge. Pipette serum separated from clot into a sterile, leak-proof container.
CSF: Sterile transport tube
Serum/CSF: 0.5 mL
Room Temperature: 30 days
Refrigerated: 30 days
Frozen: 30 days
>30 days old
Two unique patient identifiers are required on the specimen container.
Any specimen type other than serum or cerebrospinal fluid (CSF)
For specimen submissions that do not meet these criteria, please call Customer Service.
Ambient/Refrigerated/Frozen
Ship to arrive Monday‐Friday using a next day delivery service. Samples may be shipped on dry ice, frozen ice packs, or ambient.
Testing is performed Monday through Friday and reported the by the next day
Negative
Negative: <1.0 EU
Positive: ≥1.0 EU
CSF will be run with a non-validated disclaimer.
Results should be correlated with clinical presentation and history.
This test was developed, and its analytical performance characteristics determined by MiraVista Diagnostics. It has not been cleared or approved by the FDA; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.