Ordering Recommendation

Aid in diagnosis of coccidioidal meningitis (Valley fever).

Mnemonic
COCCIABCSF
Methodology

Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion/Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Sun-Sat

Reported

2-5 days

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

CSF.

Specimen Preparation

Transfer 2.5 mL CSF to an ARUP Standard Transport Tube. (Min: 1 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens.

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Other body fluids. 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
Test Number
Components
Reference Interval
3000058 Coccidioides immitis by Immunodiffusion, CSF None detected.
3000059 Coccidioides Antibody by CF, CSF Less than 1:2
3000055 Coccidioides Antibody IgG ELISA, CSF
0.9 IV or less Negative - No significant level of Coccidioides IgG antibody detected.
1.0-1.4 IV Equivocal - Questionable presence of Coccidioides IgG antibody detected. Repeat testing in 10-14 days may be helpful.
1.5 IV or greater Positive - Presence of IgG antibody to Coccidioides detected, suggestive of current or past infection.

3000056 Coccidioides Antibody IgM ELISA, CSF
0.9 IV or less Negative - No significant level of Coccidioides IgM antibody detected.
1.0-1.4 IV Equivocal - Questionable presence of Coccidioides IgM antibody detected. Repeat testing in 10-14 days may be helpful.
1.5 IV or greater Positive - Presence of IgM antibody to Coccidioides detected, suggestive of current or recent infection.

Interpretive Data

Refer to report.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note

For Coccidioides, immunodiffusion (ID) measures IgM antibody, while complement fixation (CF) measures both IgG and IgM. ELISA tests can be used to detect both coccidioidal IgG and IgM antibodies. While elevated single antibody titers may be diagnostic, paired specimens are preferred. Acute and convalescent specimens (drawn at least 21 days apart), showing a fourfold or greater rise in titer, are diagnostic.

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

Hotline History
N/A
CPT Codes

86635 x4

Components
Component Test Code* Component Chart Name LOINC
0050711 Coccidioides Ab by CF, CSF 13917-0
3000062 Coccidioides Antibody IgG ELISA, CSF 16638-9
3000063 Coccidioides Antibody IgM ELISA, CSF 16639-7
3000064 Coccidioides by Immunodiffusion, CSF 21209-2
* 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
Coccidioides Antibodies Panel, CSF by CF, ID, ELISA