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Epic Code LAB848 Histoplasma Antibody, Spinal Fluid

Important Note

Order as Reference Miscellaneous #LAB848, indicate complete test name when ordering.

Additional Codes

Mayo Code: CHIST

Reporting Name

Histoplasma Ab, CSF

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Clinical Information

Histoplasma capsulatum is a soil saprophyte that grows well in soil enriched with bird droppings. The usual disease is self-limited, affects the lungs, and is asymptomatic. Chronic cavitary pulmonary disease, disseminated disease, and meningitis may occur and can be fatal, especially in young children and immunosuppressed patients.

Useful For

Aiding in the diagnosis of Histoplasma meningitis in spinal fluid specimens

Specimen Type

CSF
Laboratory Test Directory Note:

Lab Central Staff: All CSF specimens to Hematology first.


Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 1 mL


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis OK
Gross lipemia OK

Day(s) Performed

Monday through Friday

Reference Values

MYCELIAL BY COMPLEMENT FIXATION (CF)

Negative (positives reported as titer)

 

YEAST BY CF

Negative (positives reported as titer)

 

ANTIBODY BY IMMUNODIFFUSION

Negative (positives reported as band present)

Interpretation

Any positive serologic result in spinal fluid is significant.

 

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

 

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

Cautions

Antibody levels may be low in spinal fluid in cases of Histoplasma meningitis.

 

Histoplasmin skin tests yield specific antibodies in titratable quantity and may cause difficulties in interpretation.

 

Cross-reacting antibodies with coccidioidomycosis or blastomycosis may cause false-positive results for Histoplasmosis.

Clinical Reference

1. Kaufman L, Kovacs JA, Reiss E: Clinical immunomycology. In: Manual of Clinical and Laboratory Immunology. ASM Press.1997

2. Deepe GS: Histoplasma capsulatum Histoplasmosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:3162-3176

Method Name

Complement Fixation (CF)/Immunodiffusion

Method Description

Both immunodiffusion and compliment fixation (CF) tests are used to detect antibodies to Histoplasma capsulatum. For immunodiffusion, 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 Histoplasma capsulatum; the latter is more sensitive.(Roberts GD: Fungi. In: Washington II, JA eds. Laboratory Procedures in Clinical Microbiology. 2nd ed. Edited by JA Washington II. Springer-Verlag. 1985; Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020)

Report Available

2 to 7 days

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 x 3

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CHIST Histoplasma Ab, CSF 91684-1

 

Result ID Test Result Name Result LOINC Value
15118 Histoplasma Mycelial (CSF) 27220-3
15119 Histoplasma Yeast (CSF) 27209-6
15120 Histoplasma Immunodiffusion (CSF) 91682-5

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.