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Test Code HIBC Histoplasma/Blastomyces Panel, Spinal Fluid


Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 1.5 mL

Collection Instructions: Submit specimen from collection vial 1.


Useful For

Aiding in the diagnosis of histoplasmosis or blastomycosis meningitis

Profile Information

Test ID Reporting Name Available Separately Always Performed
HICSF Histoplasma Ab CompFix/ImmDiff, CSF Yes Yes
CBL Blastomyces Ab Immunodiffusion, CSF Yes Yes

Testing Algorithm

For more information see Meningitis/Encephalitis Panel Algorithm

Method Name

HICSF: Complement Fixation (CF)/Immunodiffusion (ID)

CBL: Immunodiffusion (ID)

Reporting Name

Histoplasma/Blastomyces Panel,CSF

Specimen Type

CSF

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values

HISTOPLASMA ANTIBODY

Anti-Yeast antibody by Complement Fixation: Negative (positive results reported as titer)

Antibody by Immunodiffusion: Negative (positive results reported as titer)

 

BLASTOMYCES ANTIBODY IMMUNODIFFUSION

Negative

Interpretation

Histoplasma:

-Any positive serologic result in spinal fluid is significant.

-Simultaneous appearance of the H and M precipitin bands suggests active histoplasmosis.

-The M band alone indicates active or chronic disease or a recent skin test for histoplasmosis.

 

Blastomyces:

A positive result is suggestive of infection, but the results cannot distinguish between active disease and prior exposure. Furthermore, detection of antibodies in cerebrospinal fluid (CSF) may reflect intrathecal antibody production or may occur due to passive transfer or introduction of antibodies from the blood during lumbar puncture.

 

Routine fungal culture of clinical specimens (eg, CSF) is recommended in cases of suspected blastomycosis involving the central nervous system.

Clinical Reference

Histoplasma

Both immunodiffusion (ID) and compliment fixation (CF) tests are used to detect antibodies to Histoplasma capsulatum. For ID, the antigen is a culture filtrate, histoplasmin. H and M precipitin bands are identified. For the CF test, the antigens are histoplasmin and a yeast form of H capsulatum; the latter is more sensitive.(Roberts GD: Fungi. In: Washington II JA, ed. Laboratory Procedures in Clinical Microbiology. 2nd ed. Springer-Verlag, 1985; In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020)

 

Blastomyces

The ID test is a qualitative test employed for the detection of precipitating antibodies present in the specimen. Soluble antigens of the fungus are placed in wells of an agarose gel-filled Petri dish, and the patient's specimen and a control (positive) are placed in adjoining wells. If present, specific precipitate antibody will form precipitin lines between the wells. Their comparison to the control establishes the results. When performing the ID test, only precipitin bands of identity with the reference bands are significant.(Kaufman L, McLaughlin DW, Clark MJ, Blumer S: Specific immunodiffusion test for blastomycosis. Appl Microbiol. 1973;26:244-247, Williams JE, Murphy R, Standard PG, Phan JP: Serologic response in blastomycosis: diagnostic value of double immunodiffusion assay. Am Res Resp Dis. 1981;123:209-212; Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020)

Day(s) Performed

Monday through Friday

Report Available

3 to 7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86698 x2

86612

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HIBC Histoplasma/Blastomyces Panel,CSF 91683-3

 

Result ID Test Result Name Result LOINC Value
15134 Blastomyces Immunodiffusion (CSF) 51741-7
621217 Histoplasma Yeast CompFix, CSF 27209-6
621218 Histoplasma Immunodiffusion, CSF 91682-5