ArticleOpen forum infectious diseases2025
Performance of Diagnostic Tests for Histoplasmosis Across Clinical Syndromes and Immune Statuses.
Article in Open forum infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Disseminated histoplasmosis evading detection in an immunocompromised patient.Medical mycology case reports · 2026Article
- Role of Blastomyces BAD-1 IgG Enzyme Immunoassay (EIA) for the diagnosis of blastomycosis in persons residing in an endemic area.Medical mycology · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Histoplasmosis, caused by Methods: We conducted a retrospective diagnostic study of adults evaluated at Indiana University Health Medical Center who had serum and/or urine submitted for Histoplasma antigen testing to Miravista Diagnostics. Clinical classification (proven, probable) was based on laboratory, imaging, and clinical data according to EORTC/MSG criteria. Controls were patients tested for histoplasmosis but found to have an alternative diagnosis. Diagnostic methods included antigen enzyme immunoassay (EIA), antibody EIA (IgG/IgM), immunodiffusion (ID), complement fixation (CF), and fungal cultures. Results: Among 205 patients, 125 were classified as histoplasmosis (54 proven, 71 probable) and 80 as controls. Antigen EIA in serum and/or urine had sensitivity 121/124 (97.6%) and specificity 75/80 (93.7%). IgG/IgM antibody EIA detected 89/111 (80.2%) cases with specificity 73/79 (92.4%) at a 20 EU/mL cutoff. Combining antigen and antibody testing increased sensitivity to 109/110 (99.1%). Among 75 patients with both serum and urine antigen tested, combined testing added 3/75 (4%) cases beyond urine alone. Antibody sensitivity declined in immunocompromised patients (75.0% vs 93.3% in immunocompetent, Conclusions: Histoplasma antigen testing is the most sensitive diagnostic method. Antibody testing complements antigen in selected populations, particularly immunocompetent patients with pulmonary disease. Culture remains a complementary but less sensitive tool.
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