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Test Code COCCIDO AB Coccidioides Antibody, Serum

Reporting Name

Coccidioides Ab, S

Useful For

Diagnosing coccidioidomycosis

 

Serologic testing for coccidioidomycosis should be considered when patients exhibit symptoms of pulmonary or 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 a diagnosis of coccidioidomycosis is being considered.


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1.8 mL


Seattle Children's Hospital Note:

Collect 4.0 mL whole blood in a Red top.

Specimen Type

Serum

Specimen Minimum Volume

1.2 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Day(s) and Time(s) Performed

Monday through Friday; 9:30 a.m.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Method Name

Complement Fixation (CF) Using Coccidioidin: IgG
Immunodiffusion: IgG and IgM

Method Description

Complement Fixation (CF):

Antibody to coccidioidin in the patient's serum is quantitated by CF. The CF test is a 2-stage test based on the ability of antigen-antibody complexes to bind complement (C’). In the first stage, antigen and antibody combine and fix C’. The second stage is an indicator system in which sheep erythrocytes, sensitized by rabbit anti-sheep red cell antibody (hemolysin), are used to demonstrate the presence of unfixed C’. If the patient’s serum contains C’-fixing antibody that reacts with the specific antigen (a positive reaction), C’ will be fixed and excess C’ will not be available to react with and lyse the sensitized sheep erythrocytes. If no antigen-antibody reaction occurs (a negative reaction), C’ will be available to lyse the sheep erythrocytes. The CF titer is determined by the greatest dilution of serum (antibody) in which the sheep erythrocytes are not lysed.(Kaufman L, Kovacs JA, Reiss E: Immunomycology. In Manual of Clinical Laboratory Immunology. Fifth edition. Edited by NR Rose, ED de Macario, JD Folds, et al. Washington, DC, ASM Press, 1997 pp 591-592; Pappagianis D, Zimmer BL: Serology of coccidioidomycosis. Clin Microbiol Rev 1990;3:247-268)

 

Immunodiffusion (ID):

ID is a qualitative test employed for the detection of precipitating antibodies present in the serum. Soluble antigens of the fungus are placed in wells of an agarose gel filled Petri dish and the patient’s serum and a control (positive) serum are placed in adjoining wells. If present, specific precipitate antibody will form precipitin lines between the wells. Their comparison to the control serum establishes the results. When performing the ID test, only precipitin bands of identity with the reference bands are significant.(Kaufman L, Kovacs JA, Reiss E: Immunomycology. In Manual of Clinical Laboratory Immunology. Fifth edition. Edited by NR Rose,EC de Macario, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 591-593; Pappagianis D, Zimmer BL: Serology of coccidioidomycosis. Clin Microbiol Rev 1990;3:247-268)

Reference Values

COMPLEMENT FIXATION

Negative

If positive, results are titered.

 

IMMUNODIFFUSION

Negative

Results are reported as positive, negative, or equivocal.

Test Classification

This test uses a standard method. 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 U.S. Food and Drug Administration.

CPT Code Information

86635 x 3

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SCOC Coccidioides Ab, S 87435-4

 

Result ID Test Result Name Result LOINC Value
8295 Cocci Complement F 5096-3
21649 Cocci Immunodiffusion-IgG 62459-3
21648 Cocci Immunodiffusion-IgM 62458-5

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

NA

Other

NA