Test Id : COXIS
Coccidioides Antibody Screen with Reflex, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detecting antibodies to Coccidioides immitis/posadasii
This assay should not be used for monitoring response to therapy.
Highlights
Alongside other routine laboratory testing, including fungal culture, this test may be used as an aid for the diagnosis of infection with Coccidioides species.
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| RSCOC | Coccidioides Ab, CompF/ImmDiff,S | Yes, (order SCOC) | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If result is reactive, then Coccidioides by complement fixation and immunodiffusion will be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Method Name
A short description of the method used to perform the test
COXIS: Enzyme Immunoassay (EIA)
RSCOC: Complement Fixation (CF)/Immunodiffusion (ID)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Cocci
Coccidioides immitis
Coccidioides posadasii
Coccidioides, Serum
Fungal Serology
San Joaquin Valley Fever
COXIS
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If result is reactive, then Coccidioides by complement fixation and immunodiffusion will be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Specimen Type
Describes the specimen type validated for testing
Serum
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
1.7 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Detecting antibodies to Coccidioides immitis/posadasii
This assay should not be used for monitoring response to therapy.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If result is reactive, then Coccidioides by complement fixation and immunodiffusion will be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Coccidioidomycosis (valley fever, San Joaquin Valley fever, desert rheumatism) is caused by the dimorphic fungus Coccidioides immitis/posadasii, which is found in the Southwestern US, regions in the Northwestern US, and in Central and South America. It is acquired by inhalation of airborne Coccidioides arthroconidia. The majority of infections are subclinical. Among symptomatic patients, the majority will present acute flulike, pulmonary symptoms approximately 7 to 28 days post exposure. Symptoms may include chest pain, cough, fever, malaise, and lymphadenopathy.(1) A rash often develops within a couple of days, followed by erythema nodosum or multiforme with accompanying arthralgia. A pulmonary lesion or nodule may develop months following infection and may be a source of infection if the patient becomes immunosuppressed in the future. Coccidioidomycosis may disseminate beyond the lungs to involve multiple organs including the meninges. Individuals at greater risk for dissemination include African Americans, patients of Filipino descent, pregnant women, and immunocompromised patients.(2)
Serologic testing for coccidioidomycosis should be considered when patients exhibit symptoms of pulmonary or meningeal infection and have lived or traveled in areas where C immitis/posadasii is endemic. Any history of exposure to the organism or travel cannot be overemphasized when a diagnosis of coccidioidomycosis is being considered.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative
Reference value applies to all ages
Interpretation
Provides information to assist in interpretation of the test results
Enzyme immunoassay (EIA) results greater than or equal to 0.75 will be reported as Reactive: Confirmatory testing by complement fixation and immunodiffusion has been ordered.
A reactive result is presumptive evidence that the patient was previously or is currently infected with Coccidioides immitis/posadasii.
EIA results less than 0.75 will be reported as Negative: Repeat testing on a new sample in 2 to 3 weeks if clinically indicated.
A negative result indicates the absence of antibodies to C immitis/posadasii. It is presumptive evidence that the patient has not been previously exposed to, and is not infected with, Coccidioides. However, a negative result does not preclude the diagnosis of coccidioidomycosis as the specimen may have been collected before antibody levels were detectable, due to early acute infection or immunosuppression.
This test is designed for the qualitative detection of both IgM- and IgG-class antibodies against antigens from Coccidioides. The report will not indicate which class of antibody is present.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
All results from this assay must be correlated with clinical history, epidemiologic data, and other laboratory evidence.
Reactive results from this assay are not indicative of acute infection. Antibodies may be present from previous infection with Coccidioides immitis/posadasii.
Negative results may occur in patients with acute coccidioidomycosis in whom antibody levels have not yet become detectable.
Rarely, cross reactivity of the Coccidioides antibody screen may occur in patients infected with other dimorphic fungal agents, including Histoplasma and Blastomyces. Therefore, all positive results must be confirmed by complement fixation and immunodiffusion.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Thompson GR 3rd: Pulmonary coccidioidomycosis. Semin Respir Crit Care Med. 2011;32(6):754-763
2. Ruddy BE, Mayer AP, Ko MG, et al. Coccidioidomycosis in African Americans. Mayo Clin Proc. 2011;86(1):63-69
3. Crum NF. Coccidioidomycosis: a contemporary review. Infect Dis Ther. 2022;11(2):713-742. doi:10.1007/s40121-022-00606-y
Method Description
Describes how the test is performed and provides a method-specific reference
Microwells are coated with recombinant Coccidioides complement fixing (CF) and tube precipitin (TP) antigens. Diluted serum specimens and controls are incubated in the wells, and if present, antibodies to TP and CF will bind to the adhered antigen. Nonspecific reactants are removed by washing; peroxidase-conjugated, secondary antihuman antibody is then applied to the wells and incubated. The conjugated secondary antibody will bind to the patient antibodies. Substrate solution is added to the wells, activating the peroxidase conjugate to develop a color reaction. Stop solution is added and the color change is quantified by measuring the optical density.(Package insert: clarus Cocci AB EIA. Immy; Revision 03/06/2020)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86635
86635 x3 (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| COXIS | Coccidioides Ab Screen w/Reflex, S | 40712-2 |
| 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.
|
|---|---|---|
| COXQ2 | Coccidioides Ab Screen, S | 40712-2 |