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Coccidioides Antibody, EIA with Reflex to Immunodiffusion (ID) and CF
Test Code18175
CPT Codes
86635
Includes
If Coccidioides is Positive or Indeterminate, then Coccidioides Antibody, Complement Fixation, Serum and Coccidioides Antibodies (IgG, IgM), Immunodiffusion will be performed at an additional charge (CPT Code(s): 86317, 86635 (x2)).
Preferred Specimen
1 mL serum
Minimum Volume
0.5 mL
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days
Refrigerated: 14 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic • Grossly icteric
Methodology
Immunoassay (IA)
Setup Schedule
Set up: Tues, Thurs, Sat; Report available: 2-4 days
Reference Range
| Coccidioides Ab, EIA, Serum | Negative |
| Ab to TP Antigen(IgM), ID | Negative |
| Ab to F Antigen (IgG), ID | Negative |
| Coccidioides Ab, CF, Serum | <1:2 Titer |
Clinical Significance
This test is intended to aid in the initial diagnosis of coccidioidomycosis (Valley Fever). The test includes an initial enzyme immunoassay (EIA) screening assay used for the qualitative detection of antibodies against the TP and CF antigens of Coccidioides. Specimens with positive (or indeterminate) EIA results reflex to IgG and IgM immunodiffusion (ID) and complement fixation (CF) assays for confirmation of laboratory diagnosis.
Coccidioides is a fungal disease primarily caused by inhalation of spores found in the soil in endemic areas (e.g. Southwestern United States and parts of Mexico, Central and South America). Serologic testing can be performed in patients with suspected Coccidioides infection who present with consistent signs, symptoms, and risk factors, including those presenting with community-acquired pneumonia. A positive result using EIA is followed up by ID and CF to confirm diagnosis.
For specimens with negative EIA results from patients who remain under high degree of suspicion for coccidioidomycosis, consider repeating serology testing 2-6 weeks after initial EIA. Antibody testing can be negative early in the course of illness. Numerous reports have noted significant antibody cross-reactivity with patients suffering from other fungal diseases, including histoplasmosis, blastomycosis, and aspergillosis. The results of this test should be interpreted in the context of pertinent clinical history and physical examination findings.
References:
1. Smith DJ, et al. Clinical Testing Guidance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis in Patients with Community-Acquired Pneumonia for Primary and Urgent Care Providers. Clin Infect Dis. 2023 Jul 24 doi: 10.1093/cid/ciad619
2. Thompson G and Gomez B. Section VI. Mycology: Histoplasma, Blastomyces, Coccidioides, Paracoccidioides and Other Dimorphic Fungi Causing Systemic Mycoses. Manual of Clinical Microbiology. 2023 Aug 11. DOI: 10.1002/9781683670438.mcm0126
Coccidioides is a fungal disease primarily caused by inhalation of spores found in the soil in endemic areas (e.g. Southwestern United States and parts of Mexico, Central and South America). Serologic testing can be performed in patients with suspected Coccidioides infection who present with consistent signs, symptoms, and risk factors, including those presenting with community-acquired pneumonia. A positive result using EIA is followed up by ID and CF to confirm diagnosis.
For specimens with negative EIA results from patients who remain under high degree of suspicion for coccidioidomycosis, consider repeating serology testing 2-6 weeks after initial EIA. Antibody testing can be negative early in the course of illness. Numerous reports have noted significant antibody cross-reactivity with patients suffering from other fungal diseases, including histoplasmosis, blastomycosis, and aspergillosis. The results of this test should be interpreted in the context of pertinent clinical history and physical examination findings.
References:
1. Smith DJ, et al. Clinical Testing Guidance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis in Patients with Community-Acquired Pneumonia for Primary and Urgent Care Providers. Clin Infect Dis. 2023 Jul 24 doi: 10.1093/cid/ciad619
2. Thompson G and Gomez B. Section VI. Mycology: Histoplasma, Blastomyces, Coccidioides, Paracoccidioides and Other Dimorphic Fungi Causing Systemic Mycoses. Manual of Clinical Microbiology. 2023 Aug 11. DOI: 10.1002/9781683670438.mcm0126
