Sensitivity of Serologic Assays in Culture-Confirmed Histoplasmosis

Although far from perfect, commercially available complement fixation and immunodiffusion assays are useful in the diagnosis of histoplasmosis.

Histoplasma capsulatum is a dimorphic fungus endemic to the Ohio and Mississippi river valleys that can cause serious illness in hosts with compromised immunity. While tissue culture and histopathology remain the gold-standard diagnostic tests for histoplasmosis, invasive sampling procedures are not always clinically possible. Complement fixation (CF) and immunodiffusion (ID) serologic tests are favored over simpler (but less reliable) enzyme immunoassays, but contemporary CF/ID tests have not recently been compared to gold-standard culture methods.

Fida and colleagues identified 67 culture-confirmed cases of histoplasmosis from 2011 to 2021 in which concomitant CF and ID testing was performed (median age, 59; 66% male; 67% immunocompromised…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases