Ordering Recommendation

Titers may aid in monitoring coccidioidal meningitis (Valley fever) and treatment response. For initial establishment of diagnosis, refer to Coccidioides Antibodies Panel, CSF by CF, ID, ELISA (3000061) which combines complement fixation, immunodiffusion, and enzyme-linked immunosorbent assays.

Mnemonic
COCCICFCSF
Methodology

Semi-Quantitative Complement Fixation

Performed

Sun-Sat

Reported

2-4 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

CSF.

Specimen Preparation

Transfer 1 mL CSF to an ARUP Standard Transport Tube. (Min 0.6 mL) Parallel testing is preferred and convalescent specimens must be recieved within 30 days from receipt of acute specimens.

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Contaminated, hemolyzed, xanthochromic, or severely lipemic specimens.

Remarks

Mark specimens plainly as "acute" or "convalescent."

Stability

Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

Reference Interval

Less than 1:2

Interpretive Data

Any titer suggests past or current infection. However, greater than 30 percent of cases with chronic residual pulmonary disease have negative Complement Fixation (CF) tests. Titers of less than 1:32 (even as low as 1:2) may indicate past infection or self-limited disease anticoccidioidal CF antibody titers in excess of 1:16 may indicate disseminated infection. CF serology may be used to follow therapy. Antibody in CSF is considered diagnostic for coccidioidal meningitis, although 10 percent of patients with coccidioidal meningitis will not have antibody in CSF.

Compliance Category

Modified FDA

Note

CF measures both IgM and IgG. As single antibody titers are generally not diagnostic, paired specimens are preferred. Acute and convalescent specimens (drawn at least 21 days apart) showing at least a fourfold rise in titer are diagnostic.

Negative fungal serology does not rule out the possibility of current infection.

Hotline History
N/A
CPT Codes

86635

Components
Component Test Code* Component Chart Name LOINC
0050711 Coccidioides Ab by CF, CSF 13917-0
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Cocci IgG, IgM CF
  • Coccidioidomycosis IgG/IgM
  • San Joaquin Fever Antibody
  • Valley Fever antibodies
Coccidioides Antibody by CF, CSF