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Clin Infect Dis. 2016 Apr 1;62(7):896-902. doi: 10.1093/cid/ciw007. Epub 2016 Jan 20.

Improved Diagnosis of Acute Pulmonary Histoplasmosis by Combining Antigen and Antibody Detection.

Author information

1
MiraVista Diagnostics.
2
Richard M. Fairbanks School of Public Health, Indiana University-Purdue University.
3
Thoracic Transplantation Program, Indiana University Health-Methodist Hospital.
4
Department of Pathology, Indiana University School of Medicine, Sidney & Lois Eskenazi Hospital, Indianapolis.

Abstract

BACKGROUND:

Acute pulmonary histoplasmosis can be severe, especially following heavy inoculum exposure. Rapid diagnosis is critical and often possible by detection of antigen, but this test may be falsely negative in 17% of such cases. Antibody detection by enzyme immunoassay (EIA) may increase sensitivity and permit the measurement of immunoglobulin M (IgM) and immunoglobulin G (IgG) classes of antibodies separately.

METHODS:

Microplates coated with Histoplasma antigen were used for testing of serum from patients with acute pulmonary histoplasmosis and controls in the MVista Histoplasma antibody EIA. Results for IgG and IgM were reported independently.

RESULTS:

IgG antibodies were detected in 87.5%, IgM antibodies in 67.5%, and IgG and/or IgM antibodies in 88.8% of patients with acute pulmonary histoplasmosis in this assay, while immunodiffusion, complement fixation, and antigen testing showed sensitivities of 55.0%, 73.1%, and 67.5%, respectively (n = 80). Combining antigen and antibody detection increased the sensitivity to 96.3%.

CONCLUSIONS:

The MVista Histoplasma antibody EIA offers increased sensitivity over current antibody tests while also allowing separate detection of IgG and IgM antibodies and complementing antigen detection. Combining antigen and EIA antibody testing provides an optimal method for diagnosis of acute pulmonary histoplasmosis.

KEYWORDS:

Histoplasma capsulatum; acute pulmonary histoplasmosis; serology

PMID:
26797210
PMCID:
PMC4787609
DOI:
10.1093/cid/ciw007
[Indexed for MEDLINE]
Free PMC Article

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