Aiding in the diagnosis of Histoplasma meningitis
Detecting antibodies in patients with blastomycosis
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
CHIST | Histoplasma Ab, CSF | Yes | Yes |
CBL | Blastomyces Ab Immunodiffusion, CSF | Yes | Yes |
For more information see Meningitis/Encephalitis Panel Algorithm
CHIST: Complement Fixation (CF)/Immunodiffusion (ID)
CBL: Immunodiffusion (ID)
Blastomyces dermatitidis
Blastomycosis
Fungal Serology
Histoplasma capsulatum
Histoplasmosis
For more information see Meningitis/Encephalitis Panel Algorithm
CSF
Container/Tube: Sterile vial
Specimen Volume: 1.5 mL
Collection Instructions: Submit specimen from collection vial 2.
1 mL
Gross hemolysis | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Refrigerated (preferred) | 14 days | |
Frozen | 14 days |
Aiding in the diagnosis of Histoplasma meningitis
Detecting antibodies in patients with blastomycosis
For more information see Meningitis/Encephalitis Panel Algorithm
Histoplasma
Histoplasma capsulatum is a soil saprophyte that grows well in soil enriched with bird droppings. The usual disease is self-limited, asymptomatic, and affects the lungs. Chronic cavitary pulmonary disease, disseminated disease, and meningitis may occur and can be fatal, especially in young children and immunosuppressed patients.
Blastomyces
The dimorphic fungus, Blastomyces dermatitidis, causes blastomycosis. When the organism is inhaled, it causes pulmonary disease: cough, pain, and hemoptysis, along with fever and night sweats. It commonly spreads to the skin, bone, or internal genitalia where suppuration and granulomas are typical. Occasionally, primary cutaneous lesions after trauma are encountered; however, this type of infection is uncommon. Central nervous system disease is uncommon.
HISTOPLASMA ANTIBODY
Mycelial by complement fixation: Negative
Yeast by complement fixation: Negative
Antibody by immunodiffusion: Negative
BLASTOMYCES ANTIBODY IMMUNODIFFUSION
Negative
Histoplasma:
-Any positive serologic result in spinal fluid is significant.
-Simultaneous appearance of the H and M precipitin bands indicates active histoplasmosis.
-The M band alone indicates active or chronic disease or a recent skin test for histoplasmosis.
Blastomyces:
A positive result is suggestive of infection, but the results cannot distinguish between active disease and prior exposure. Furthermore, detection of antibodies in cerebrospinal fluid (CSF) may reflect intrathecal antibody production or may occur due to passive transfer or introduction of antibodies from the blood during lumbar puncture.
Routine fungal culture of clinical specimens (eg, CSF) is recommended in cases of suspected blastomycosis involving the central nervous system.
Histoplasma:
-Antibody levels may be low in spinal fluid in cases of Histoplasma meningitis.
-Histoplasmin skin tests yield specific antibodies in titratable quantity, and may cause difficulties in interpretation.
-Cross-reacting antibodies with coccidioidomycosis or blastomycosis may cause false-positive results for histoplasmosis.
Blastomyces:
-A negative result does not rule out blastomycosis.
-Patients with histoplasmosis may have low-titered cross reactions.
1. Kaufman L, Kovacs JA, Reiss E: Clinical immunomycology. In: Rose NL, Conway-de Macario E, Folds JD, Lane HC, Nakamura RM, eds. Manual of Clinical Laboratory Immunology. ASM Press; 1997:588-589
2. Gauthier GM, Klein BS: Blastomycosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:3177-3189
3. Deepe GS: Histoplasma capsulatum Histoplasmosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:3162-3176
Histoplasma
Both immunodiffusion (ID) and compliment fixation (CF) tests are used to detect antibodies to Histoplasma capsulatum. For ID, the antigen is a culture filtrate, histoplasmin. H and M precipitin bands are identified. For the CF test, the antigens are histoplasmin and a yeast form of H capsulatum; the latter is more sensitive.(Roberts GD: Fungi. In: Washington II JA, ed. Laboratory Procedures in Clinical Microbiology. 2nd ed. Springer-Verlag, 1985; In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020)
Blastomyces
The ID test is a qualitative test employed for the detection of precipitating antibodies present in the specimen. Soluble antigens of the fungus are placed in wells of an agarose gel-filled Petri dish, and the patient's specimen and a control (positive) are placed in adjoining wells. If present, specific precipitate antibody will form precipitin lines between the wells. Their comparison to the control establishes the results. When performing the ID test, only precipitin bands of identity with the reference bands are significant.(Kaufman L, McLaughlin DW, Clark MJ, Blumer S: Specific immunodiffusion test for blastomycosis. Appl Microbiol. 1973;26:244-247, Williams JE, Murphy R, Standard PG, Phan JP: Serologic response in blastomycosis: diagnostic value of double immunodiffusion assay. Am Res Resp Dis. 1981;123:209-212; Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020)
Monday through Friday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
86698 x3
86612
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
HICBL | Histoplasma/Blastomyces Panel, CSF | 91683-3 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
15134 | Blastomyces Immunodiffusion (CSF) | 51741-7 |
15118 | Histoplasma Mycelial (CSF) | 27220-3 |
15119 | Histoplasma Yeast (CSF) | 27209-6 |
15120 | Histoplasma Immunodiffusion (CSF) | 91682-5 |
Change Type | Effective Date |
---|---|
Test Status - Test Resumed | 2023-03-17 |
Test Status - Test Down | 2022-01-04 |