Coccidioides Antibody Screen, Reflex to CF & ID (Sendout)

Useful For:

• Detection of antibodies to Coccidioides immitis/posadasii
• This assay should not be used for monitoring response to therapy.

Testing Algorithm: If result is positive, then Coccidioides by complement fixation and immunodiffusion will be performed at additional charge.

Ordering Guidance: Preferred initial Coccidioides antibody screening test. Refer to Coccidioides Antibody, for follow-up, CF & ID (Sendout) [RSCOCC] for monitoring of known positives.

Coccidioides Antibody Screen: Enzyme Immunoassay (EIA)

Reflex, if performed: Complement Fixation (CF) and Immunodiffusion (ID)

Interpretation:

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 – 3 weeks if clinically indicated.

A negative result indicates the absence of antibodies to Coccidioides immitis/posadasii and 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 drawn before antibodies 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:

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.

Outside Laboratories: Centrifuge sample and aliquot serum to a separate plastic vial. Refrigerate serum while awaiting shipment. Transport with a cold pack.

Stability: Refrigerated (preferred): 14 days; Frozen: 14 days; Ambient: Unacceptable.

Reject Due To: Gross hemolysis, gross lipemia.

Centrifuge sample and aliquot serum to two separate plastic vials. If sample volume is low, prioritize the sendout test (RCOXIS).

• RCOXIS: Refrigerate serum in Sendouts Mayo Rack (95).
• UW449: Forward sample to UW-MT Microbiology Lab.

Sendouts:

• Order Mayo Test: COXIS
• Interfaced: Yes [Interface: 601; Worksheet: MARF]

Stability: Refrigerated (preferred): 14 days; Frozen: 14 days; Ambient: Unacceptable.

Reject Due To: Gross hemolysis, gross lipemia.