ArticleChest2013
Coccidioidomycosis: adenosine deaminase levels, serologic parameters, culture results, and polymerase chain reaction testing in pleural fluid.
Article in Chest, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed.
- Drug Discovery and Repurposing forJournal of fungi (Basel, Switzerland) · 2025Review
- Coccidioidomycosis: a growing global concern.The Journal of antimicrobial chemotherapy · 2025Review
- Atypical Pleural Effusion in an Immunocompetent Patient With Valley Fever: A Case Study and Review of the Literature.Cureus · 2024Article
- Unique presentation of an endemic opportunistic fungal infection: Disseminated coccidioidomycosis mimicking metastatic lung cancer with endotracheal and endobronchial involvement.Respiratory medicine case reports · 2024Article
- Clinical Cases of Coccidioidomycosis in the Americas in the Period 1950-2021: Epidemiology Data, Diagnosis, and Treatment.Life (Basel, Switzerland) · 2023Review
- Review of Clinical and Laboratory Diagnostics for Coccidioidomycosis.Journal of clinical microbiology · 2023Review
- Coccidioidomycosis: A Contemporary Review.Infectious diseases and therapy · 2022Review
- Diagnosis of Breakthrough Fungal Infections in the Clinical Mycology Laboratory: An ECMM Consensus Statement.Journal of fungi (Basel, Switzerland) · 2020Article
- Early Events in Coccidioidomycosis.Clinical microbiology reviews · 2019Review
- Multicenter Clinical Validation of a Cartridge-Based Real-Time PCR System for Detection of Coccidioides spp. in Lower Respiratory Specimens.Journal of clinical microbiology · 2018Article
- Endemic Mycoses: What's New About Old Diseases?Current clinical microbiology reports · 2016Review
- Application of Culture-Independent Rapid Diagnostic Tests in the Management of Invasive Candidiasis and Cryptococcosis.Journal of fungi (Basel, Switzerland) · 2015Review
- Call for a California coccidioidomycosis consortium to face the top ten challenges posed by a recalcitrant regional disease.Mycopathologia · 2015Article
- Molecular and nonmolecular diagnostic methods for invasive fungal infections.Clinical microbiology reviews · 2014Review
- An update on current and novel molecular diagnostics for the diagnosis of invasive fungal infections.Expert review of molecular diagnosticsReview
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundIn a patient with positive serum serology for coccidioidomycosis, the differential diagnosis of concurrent pleural effusions can be challenging. We, therefore, sought to clarify the performance characteristics of biochemical, serologic, and nucleic-acid-based testing in an attempt to avoid invasive procedures. The utility of adenosine deaminase (ADA), coccidioidal serology, and polymerase chain reaction (PCR) in the evaluation of pleuropulmonary coccidioidomycosis has not been previously reported.
methodsForty consecutive patients evaluated for pleuropulmonary coccidioidomycosis were included. Demographic data, pleural fluid values, culture results, and clinical diagnoses were obtained from patient chart review. ADA testing was performed by ARUP Laboratories, coccidioidal serologic testing was performed by the University of California-Davis coccidioidomycosis serology laboratory, and PCR testing was performed by the Translational Genomics Research Institute using a previously published methodology.
resultsFifteen patients were diagnosed with pleuropulmonary coccidioidomycosis by European Organization for the Research and Treatment of Cancer/Mycoses Study Group criteria. Pleural fluid ADA concentrations were < 40 IU/L in all patients (range, < 1.0-28.6 IU/L; median, 4.7). The sensitivity and specificity of coccidioidal serologic testing was 100% in this study. The specificity of PCR testing was high (100%), although the overall sensitivity remained low, and was comparable to the experience of others in the clinical use of PCR for coccidioidal diagnostics.
conclusionContrary to prior speculation, ADA levels in pleuropulmonary coccidioidomycosis were not elevated in this study. The sensitivity and specificity of coccidioidal serologic testing in nonserum samples remained high, but the clinical usefulness of PCR testing in pleural fluid was disappointing and was comparable to pleural fluid culture.
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