Sorted By Test Name - Mayo Medical Laboratories

CIMRP
88804
CBUR
82802
Negative
If positive, results are titered.
IMMUNODIFFUSION
Negative
Results are reported as positive, negative, or equivocal.
Clinical References: Larone D, Mitchell T, Walsh T: Histoplasma, blastomyces, coccidioides, and
other dimorphic fungi causing systemic mycoses. In Manual of Clinical Microbiology. 7th edition. Edited
by PR Murray, EJ Baron, MA Pfaller, et al: Washington, DC, ASM Press, 1999, pp 1260-1261
Coccidioides immitis/posadasii, Molecular Detection, PCR
Clinical Information: Coccidioidomycosis is caused by the dimorphic fungi, Coccidioides immitis
and Coccidioides posadasii. These organisms are endemic to the southwestern regions of the United
States, northern Mexico, and areas of Central and South America. The illness commonly manifests as a
self-limited upper respiratory tract infection, but can also result in disseminated disease that may be
refractory to treatment.(1) Clinical onset generally occurs 10 to 16 days following inhalation of
coccidioidal spores (arthroconidia).(2) Disease progression may be rapid in previously healthy or
immunosuppressed individuals. At present, the gold standard for the diagnosis of coccidioidomycosis is
culture of the organism from clinical specimens. Culture is highly sensitive and, with the implementation
of DNA probe assays for confirmatory testing of culture isolates, yields excellent specificity.(3) However,
growth in culture may take up to several weeks. This often delays the diagnosis and treatment of infected
individuals. In addition, the propagation of Coccidioides species in the clinical laboratory is a significant
safety hazard to laboratory personnel, serving as an important cause of laboratory-acquired infections if
the organism is not quickly identified and handled appropriately (ie, in a Biosafety Level 3 facility).
Serological tests including immunodiffusion and complement fixation are widely used for the detection of
antibody against Coccidioides. Serology for Coccidioides can be limited by delays in antibody
development or nonspecificity due to cross-reactions with other fungi. In addition, immunodiffusion and
complement fixation tests are highly labor intensive and are generally limited to reference laboratories.
Molecular methods can identify Coccidioides species directly from clinical specimens, avoiding the need
for culture and allowing for a more rapid and safer diagnosis.
Useful For: Rapid detection of Coccidioides An aid in diagnosing coccidioidomycosis
Interpretation: A positive result indicates presence of Coccidioides DNA. A negative result indicates
absence of detectable Coccidioides DNA.
Reference Values:
Not applicable
Clinical References: 1. Chiller TM, Galgiani JN, Stevens DA: Coccidioidomycosis. Infect Dis Clin
North Am 2003;17:41-57 2. Feldman BS, Snyder LS: Primary pulmonary coccidioidomycosis. Semin
Respir Infect 2001;16:231-237 3. Padhye AA, Smith G, Standard, et al: Comparative evaluation of
chemiluminescent DNA probe assays and exoantigen tests for rapid identification of Blastomyces
dermatitis and Coccidioides immitis. J Clin Microbiol 1994;32:867-870 4. Inoue T, Nabeshima K,
Kataoka H, Koono M: Feasibility of archival non-buffered formalin-fixed and paraffin-embedded tissues
for PCR amplification: an analysis of resected gastric carcinoma. Pathol Int 1996;46:997-1004
Cocklebur, IgE
Clinical Information: Clinical manifestations of immediate hypersensitivity (allergic) diseases are
caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from
immunoglobulin E (IgE)-sensitized effector cells (mast cells and basophils) when cell-bound IgE
antibodies interact with allergen. In vitro serum testing for IgE antibodies provides an indication of the
immune response to allergen(s) that may be associated with allergic disease. The allergens chosen for
testing often depend upon the age of the patient, history of allergen exposure, season of the year, and
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