Laboratory Test Guide

Coccidioides Antibody Initial Screen, Reflex to CF & ID (Sendout)

General Information

Lab Name

Coccidiodies Ab Initial Screen, Reflex to CF & ID (Sendout)

Lab Code

RCOXIS

Epic Name

Coccidiodies Ab Initial Screen, Reflex to CF & ID (Sendout)

External Test Id

COXIS

Description

Useful For:

Detection of antibodies to Coccidioides immitis/posadasii
This assay should not be used for monitoring response to therapy.

Testing Algorithm: If result is positive, then Coccidioides by complement fixation and immunodiffusion will be performed at additional charge.

Ordering Guidance: Preferred initial Coccidioides antibody screening test. Refer to Coccidioides Antibody, for follow-up, CF & ID (Sendout) [RSCOCC] for monitoring of known positives.

References

Mayo Clinical & Interpretive Information: Coccidioides Antibody Screen with Reflex, Serum
Washington State Department of Health Notifiable Conditions: Coccidioidomycosis (Valley Fever)

Synonyms

Cocci serology, Coccidioides immitis, Coccidioides posadasii, COXIS, San Joaquin Valley Fever

Components

Code	Name
RCOXSR	Coccidioides Antibody Screen

Interpretation

Method

Coccidioides Antibody Screen: Enzyme Immunoassay (EIA)

Reflex, if performed: Complement Fixation (CF) and Immunodiffusion (ID)

Reference Range

See individual components

Ref. Range Notes

Reference Values: Negative

Interpretation:

Enzyme immunoassay (EIA) results greater than or equal to 0.75 will be reported as Reactive: Confirmatory testing by complement fixation and immunodiffusion has been ordered.

A reactive result is presumptive evidence that the patient was previously or is currently infected with Coccidioides immitis/posadasii.

EIA results less than 0.75 will be reported as Negative: Repeat testing on a new sample in 2 – 3 weeks if clinically indicated.

A negative result indicates the absence of antibodies to Coccidioides immitis/posadasii and is presumptive evidence that the patient has not been previously exposed to and is not infected with Coccidioides. However, a negative result does not preclude the diagnosis of coccidioidomycosis as the specimen may have been drawn before antibodies levels were detectable due to early acute infection or immunosuppression.

This test is designed for the qualitative detection of both IgM- and IgG-class antibodies against antigens from Coccidioides. The report will not indicate which class of antibody is present.

Interferences and Limitations

Cautions:

All results from this assay must be correlated with clinical history, epidemiologic data, and other laboratory evidence.

Reactive results from this assay are not indicative of acute infection. Antibodies may be present from previous infection with Coccidioides immitis/posadasii.

Negative results may occur in patients with acute coccidioidomycosis in whom antibody levels have not yet become detectable.

Rarely, cross reactivity of the Coccidioides antibody screen may occur in patients infected with other dimorphic fungal agents including Histoplasma and Blastomyces. Therefore, all positive results must be confirmed by complement fixation and immunodiffusion.

Guidelines

Washington DOH Notifiable Conditions

Ordering & Collection

Specimen Type

Blood

Collection

6 mL blood in GOLD SST or RED TOP tube

Handling Instructions

Outside Laboratories: Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.

Stability: Refrigerated (preferred): 14 days; Frozen: 14 days; Ambient: Unacceptable.

Reject Due To: Gross hemolysis, gross lipemia.

Quantity

requested: 2 mL serum
minimum: 1.7 mL serum

Processing

Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.

Sendouts:

Order Mayo Test: COXIS.
Interfaced: Yes.