ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Advances in Diagnosis of Progressive Pulmonary and Disseminated Coccidioidomycosis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 37 citations in OpenAlex.
- Genetic and transcriptomic determinants of disseminated coccidioidomycosis identify a founder variant inmedRxiv : the preprint server for health sciences · 2026Article
- Endemic Mycoses for Pulmonary Clinicians: From Nodules to ARDS.CHEST pulmonary · 2025Review
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- A cautionary tale of false-positive histoplasma urine antigen in an HIV patient: a case report.Access microbiology · 2025Article
- Diagnosis of Human Endemic Mycoses Caused by Thermally Dimorphic Fungi: From Classical to Molecular Methods.Journal of fungi (Basel, Switzerland) · 2024Review
- Coccidioidomycosis in Immunocompromised at a Non-Endemic Referral Center in Mexico.Journal of fungi (Basel, Switzerland) · 2024Article
- Antigenic Relatedness between Mannans fromJournal of fungi (Basel, Switzerland) · 2024Article
- Combination of metagenomic next-generation sequencing and morphology for identifyingFrontiers in medicine · 2024Article
- Utility of multimodal sampling and testing during advanced bronchoscopy for diagnosing atypical respiratory infections in aJournal of thoracic disease · 2023Article
- Diagnostic Approach to Coccidioidomycosis in Solid Organ Transplant Recipients.Journal of fungi (Basel, Switzerland) · 2023Review
- Molecular Diagnosis of Endemic Mycoses.Journal of fungi (Basel, Switzerland) · 2022Review
- Demographic and Socioeconomic Factors Associated with Fungal Infection Risk, United States, 2019.Emerging infectious diseases · 2022Review
- Immunologic Diagnosis of Endemic Mycoses.Journal of fungi (Basel, Switzerland) · 2022Review
- Update on the Epidemiology, Diagnosis, and Treatment of Coccidioidomycosis.Journal of fungi (Basel, Switzerland) · 2022Review
- Disseminated coccidioidomycosis in immunocompetent patients in non-endemic areas: a case series and literature review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Review
- Current Landscape of Coccidioidomycosis.Journal of fungi (Basel, Switzerland) · 2022Review
- Clinical Microbiology in 2021: My Favorite Studies about Everything Except My Least Favorite Virus.Clinical microbiology newsletter · 2022Article
- Educational case: Coccidioidomycosis.Academic pathology · 2022Article
- Diagnosis of Histoplasmosis Using the MVistaOpen forum infectious diseases · 2021Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibody detection is the main method for diagnosis of coccidioidomycosis, but it has limitations. The Coccidioides antigen enzyme immunoassay is recommended for testing cerebrospinal fluid in suspected meningitis. Reports on urine and serum antigen detection evaluated small numbers of patients who were mostly immunocompromised. The purpose of this study was to assess the accuracy of combined antibody and antigen detection for diagnosis.
methodsA retrospective study, including all patients in whom Coccidioides antigen detection in serum was performed between January 2013 and May 2017, was conducted at Valleywise Health Medical Center (formerly Maricopa Integrated Health System). Sensitivity and specificity of antigen and antibody were evaluated in 158 cases and 487 controls.
resultsThe sensitivity of antibody detection by immunodiffusion (ID) was 84.2%. The sensitivity of antigen detection was 57.0% if both urine and serum were tested and 36.7% if urine alone was tested. The sensitivity of combining antigen and ID antibody detection was 93.0%. The sensitivity of urine and serum antigen detection was 55.4% in proven and 58.7% in probable cases, 79.1% in disseminated and 41.6% in pulmonary cases, and 74.7% in immunocompromised and 40.0% in immunocompetent patients. Specificity was 99.4% for antigen detection and 96.5% for ID antibody detection. Diagnostic accuracy was 95.4% for ID antibody and antigen detection, 93.6% for ID antibody alone, and 89.1% for pathology or culture.
conclusionsThese findings support combined antibody and antigen detection for diagnosis of progressive coccidioidomycosis. The diagnosis may have been missed if antigen detection was not performed.
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