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Laboratory aspects in the diagnosis of coccidioidomycosis.
Ann N Y Acad Sci. 2007 Sep; 1111:301-14.AN

Abstract

Coccidioides immitis and Coccidioides posadasii, the two recognized causes of coccidioidomycosis, may be detected by direct microscopy, culture, and serologic documentation. Two useful stains include the Grocott methenamine silver (GMS) and the calcofluor white (CFW). Other useful stains used in histopathologic studies include hematoxylin-eosin (H&E) and periodic acid Schiff (PAS). Nucleic acid amplification tests (NAATs) have been introduced for detection of Coccidioides spp. in specimens, but are not yet commercially available. Isolation of Coccidioides spp. by culture is not difficult as many fungal as well as routine bacteriologic media are available. For the safe isolation of Coccidioides spp., the laboratory should maintain a biological safety level 2 or 3. Identification of Coccidioides spp. uses the organisms' phenotypic or genotypic characteristics. Phenotypic identification to genus level may be achieved by visualization of spherules in specimens and/or by the presence of arthroconidia in culture. Isolates may be confirmed as Coccidioides spp. by molecular probes. Separation of species into C. immitis and C. posadasii is best achieved by specialized molecular techniques which are not normally available in routine clinical laboratories. Humoral antibodies can be used for the diagnosis and prognosis of coccidioidomycosis. Although positive serologic results may be helpful in the diagnosis of coccidioidomycosis, negative serologic results cannot be used to rule out the disease. Enzyme immunoassays (EIA) and immunodiffusion methods are commonly used for detection of both IgM and IgG antibody groups. Sequential complement fixation (CF) studies for IgG class of antibody are useful for the prognosis of coccidioidomycosis.

Authors+Show Affiliations

Department of Clinical Pathology, Banner Good Samaritan Medical Center, 1111 E. McDowell Road, Phoenix, AZ 85006, USA. mike.saubolle@bannerhealth.com

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17363434

Citation

Saubolle, Michael A.. "Laboratory Aspects in the Diagnosis of Coccidioidomycosis." Annals of the New York Academy of Sciences, vol. 1111, 2007, pp. 301-14.
Saubolle MA. Laboratory aspects in the diagnosis of coccidioidomycosis. Ann N Y Acad Sci. 2007;1111:301-14.
Saubolle, M. A. (2007). Laboratory aspects in the diagnosis of coccidioidomycosis. Annals of the New York Academy of Sciences, 1111, 301-14.
Saubolle MA. Laboratory Aspects in the Diagnosis of Coccidioidomycosis. Ann N Y Acad Sci. 2007;1111:301-14. PubMed PMID: 17363434.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laboratory aspects in the diagnosis of coccidioidomycosis. A1 - Saubolle,Michael A, Y1 - 2007/03/15/ PY - 2007/3/17/pubmed PY - 2007/12/6/medline PY - 2007/3/17/entrez SP - 301 EP - 14 JF - Annals of the New York Academy of Sciences JO - Ann N Y Acad Sci VL - 1111 N2 - Coccidioides immitis and Coccidioides posadasii, the two recognized causes of coccidioidomycosis, may be detected by direct microscopy, culture, and serologic documentation. Two useful stains include the Grocott methenamine silver (GMS) and the calcofluor white (CFW). Other useful stains used in histopathologic studies include hematoxylin-eosin (H&E) and periodic acid Schiff (PAS). Nucleic acid amplification tests (NAATs) have been introduced for detection of Coccidioides spp. in specimens, but are not yet commercially available. Isolation of Coccidioides spp. by culture is not difficult as many fungal as well as routine bacteriologic media are available. For the safe isolation of Coccidioides spp., the laboratory should maintain a biological safety level 2 or 3. Identification of Coccidioides spp. uses the organisms' phenotypic or genotypic characteristics. Phenotypic identification to genus level may be achieved by visualization of spherules in specimens and/or by the presence of arthroconidia in culture. Isolates may be confirmed as Coccidioides spp. by molecular probes. Separation of species into C. immitis and C. posadasii is best achieved by specialized molecular techniques which are not normally available in routine clinical laboratories. Humoral antibodies can be used for the diagnosis and prognosis of coccidioidomycosis. Although positive serologic results may be helpful in the diagnosis of coccidioidomycosis, negative serologic results cannot be used to rule out the disease. Enzyme immunoassays (EIA) and immunodiffusion methods are commonly used for detection of both IgM and IgG antibody groups. Sequential complement fixation (CF) studies for IgG class of antibody are useful for the prognosis of coccidioidomycosis. SN - 0077-8923 UR - https://www.unboundmedicine.com/medline/citation/17363434/Laboratory_aspects_in_the_diagnosis_of_coccidioidomycosis_ L2 - https://doi.org/10.1196/annals.1406.049 DB - PRIME DP - Unbound Medicine ER -