Improved diagnosis of acute pulmonary histoplasmosis by combining antigen and antibody detection

Sarah M. Richer, Melinda L. Smedema, Michelle M. Durkin, Katie M. Herman, Chadi Hage, Deanna Fuller, L. Joseph Wheat

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background. Acute pulmonary histoplasmosis can be severe, especially following heavy inoculum exposure. Rapid diagnosis is critical and often possible by detection of antigen, but this test may be falsely negative in 17% of such cases. Antibody detection by enzyme immunoassay (EIA) may increase sensitivity and permit the measurement of immunoglobulin M (IgM) and immunoglobulin G (IgG) classes of antibodies separately. Methods. Microplates coated with Histoplasma antigen were used for testing of serum from patients with acute pulmonary histoplasmosis and controls in the MVista Histoplasma antibody EIA. Results for IgG and IgM were reported independently. Results. IgG antibodies were detected in 87.5%, IgM antibodies in 67.5%, and IgG and/or IgM antibodies in 88.8% of patients with acute pulmonary histoplasmosis in this assay, while immunodiffusion, complement fixation, and antigen testing showed sensitivities of 55.0%, 73.1%, and 67.5%, respectively (n = 80). Combining antigen and antibody detection increased the sensitivity to 96.3%. Conclusions. The MVista Histoplasma antibody EIA offers increased sensitivity over current antibody tests while also allowing separate detection of IgG and IgM antibodies and complementing antigen detection. Combining antigen and EIA antibody testing provides an optimal method for diagnosis of acute pulmonary histoplasmosis.

Original languageEnglish (US)
Pages (from-to)896-902
Number of pages7
JournalClinical Infectious Diseases
Volume62
Issue number7
DOIs
StatePublished - Apr 1 2016

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Histoplasmosis
Antigens
Lung
Antibodies
Immunoglobulin M
Histoplasma
Immunoenzyme Techniques
Immunoglobulin G
Immunoglobulin Isotypes
Immunodiffusion

Keywords

  • acute pulmonary histoplasmosis
  • Histoplasma capsulatum
  • serology

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Richer, S. M., Smedema, M. L., Durkin, M. M., Herman, K. M., Hage, C., Fuller, D., & Wheat, L. J. (2016). Improved diagnosis of acute pulmonary histoplasmosis by combining antigen and antibody detection. Clinical Infectious Diseases, 62(7), 896-902. https://doi.org/10.1093/cid/ciw007

Improved diagnosis of acute pulmonary histoplasmosis by combining antigen and antibody detection. / Richer, Sarah M.; Smedema, Melinda L.; Durkin, Michelle M.; Herman, Katie M.; Hage, Chadi; Fuller, Deanna; Wheat, L. Joseph.

In: Clinical Infectious Diseases, Vol. 62, No. 7, 01.04.2016, p. 896-902.

Research output: Contribution to journalArticle

Richer, SM, Smedema, ML, Durkin, MM, Herman, KM, Hage, C, Fuller, D & Wheat, LJ 2016, 'Improved diagnosis of acute pulmonary histoplasmosis by combining antigen and antibody detection', Clinical Infectious Diseases, vol. 62, no. 7, pp. 896-902. https://doi.org/10.1093/cid/ciw007
Richer, Sarah M. ; Smedema, Melinda L. ; Durkin, Michelle M. ; Herman, Katie M. ; Hage, Chadi ; Fuller, Deanna ; Wheat, L. Joseph. / Improved diagnosis of acute pulmonary histoplasmosis by combining antigen and antibody detection. In: Clinical Infectious Diseases. 2016 ; Vol. 62, No. 7. pp. 896-902.
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