title: Enhanced Antibody Detection and Diagnosis of Coccidioidomycosis with the MiraVista IgG and IgM Detection Enzyme Immunoassay.
abstract: Coccidioidomycosis is a common cause of community-acquired pneumonia in areas of the southwestern United States in which the disease is endemic. Clinical presentations range from self-limited disease to severe disseminated disease. Therefore, early and accurate diagnosis is essential to ensure appropriate treatment and monitoring. Currently available diagnostic tests have variable accuracy, particularly in certain patient populations, and new tests may offer improved accuracy for the diagnosis of coccidioidomycosis. Serum samples from 103 cases of coccidioidomycosis and 373 controls were tested for IgG and IgM antibodies using the MVista anti-Coccidioidesantibody enzyme immunoassay. Serum specimens from 170 controls from areas in which the disease is endemic and 44 cases were tested by immunodiffusion at MiraVista Diagnostics. The sensitivity of the MVista antibody assay was 88.3%, and the specificity was 90%. The sensitivity was maintained in the presence of immunocompromising conditions or immunosuppressive therapies. The sensitivity of immunodiffusion was 60.2%, and the specificity was 98.8%. The sensitivity of complement fixation (62 cases) was 66.1%, but the specificity could not be determined. The MVista anti-Coccidioidesantibody enzyme immunoassay offers improved sensitivity, compared with immunodiffusion and complement fixation, is not impaired in immunocompromised patients, and permits highly reproducible semiquantification.
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA jmalo@deptofmed.arizona.edu.
authors.forename: Joshua
authors.identifier: 0000-0003-0644-7754
authors.initials: J
authors.lastname: Malo
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Holbrook
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Tirdad
authors.initials: T
authors.lastname: Zangeneh
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Strawter
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Eyal
authors.initials: E
authors.lastname: Oren
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Robey
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Erickson
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Racquel
authors.initials: R
authors.lastname: Chahal
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Durkin
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Thompson
authors.affiliation: Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hoover
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Neil M
authors.initials: NM
authors.lastname: Ampel
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana, USA.
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Wheat
authors.affiliation: Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Knox
mesh_terms: D000908:Antibodies, Fungal / Q000097:blood*; D003045:Coccidioides / Q000276:immunology*; D003047:Coccidioidomycosis / Q000175:diagnosis*; D017714:Community-Acquired Infections / Q000175:diagnosis; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods*; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D011014:Pneumonia / Q000175:diagnosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States
chemical_list: D000908:Antibodies, Fungal; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: coccidioidomycosis; endemic mycoses; fungal infections; serology