Significance of Isolated Positive IgM Serologic Results by Enzyme Immunoassay for Coccidioidomycosis |
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Authors: | Janis E Blair Jeremiah T Currier |
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Institution: | (1) Division of Infectious Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA;(2) Northern Arizona University, Flagstaff, AZ, USA |
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Abstract: | Serologic testing is important for diagnosis of coccidioidomycosis. Many methods are available for diagnostic testing. Enzyme
immunoassay (EIA) can be performed quickly and locally but has the potential for false-positive results in patients manifesting
a positive EIA for immunoglobulin M (IgM) antibodies and a negative EIA for immunoglobulin G (IgG). We retrospectively reviewed
the charts of 405 patients with coccidioidal serologic testing performed between 1999 and 2003. Of 706 EIAs, 37 (5%) produced
test results for 28 patients that showed isolated IgM positivity. Among these 28 patients, 24 (86%) had positive serologic
findings by other methods (complement fixation or immunodiffusion or both), and 7 (25%) had positive microbiologic or histopathologic
findings. All 4 (14%) patients without other positive serologic results had diagnostic tests with positive microbiologic or
histopathologic results. No false-positive IgM assays were observed. We conclude that the false-positive rate of the EIA IgM
is low, and that an isolated positive EIA IgM should prompt further follow-up and diagnostic testing.
J. T. Currier was a Visiting Research Trainee at the Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ. |
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Keywords: | Coccidioides Immunoenzyme techniques False-positive reactions Predictive value of tests |
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