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False-positive IgM serology in coccidioidomycosis
Tim Kuberski1, Judith Herrig, D Pappagianis
1Infection Prevention Program/Quality Management, John C. Lincoln Health Network, 2423 West Dunlap Avenue, Suite 100, Phoenix, AZ 85021, USA. tjkubs@aol.com
Journal of Clinical Microbiology
|April 2, 2010
Summary
Enzyme immunoassay (EIA) tests for IgM may yield false positives in suspected coccidioidomycosis cases. A study revealed 82% of IgM-positive, IgG-negative results did not confirm the fungal infection.
Area of Science:
- Medical Diagnostics
- Mycology
- Infectious Diseases
Background:
- Coccidioidomycosis diagnosis often relies on serological tests, including enzyme immunoassays (EIA).
- IgM antibody detection is frequently used to indicate acute infection.
Observation:
- A clinical concern exists regarding a high rate of false-positive IgM EIA results in patients with suspected coccidioidomycosis.
- Patients with positive IgM EIA results are often presumed to have acute coccidioidomycosis.
Findings:
- This study investigated the diagnostic accuracy of IgM EIA in suspected coccidioidomycosis.
- A significant proportion of patients with an IgM-positive and IgG-negative EIA result did not have a confirmed diagnosis of coccidioidomycosis.
- Specifically, 82% of patients in this subgroup lacked a confirmed coccidioidomycosis diagnosis.
Implications:
- The findings suggest that IgM EIA results, particularly when IgG is negative, may not be sufficiently specific for diagnosing acute coccidioidomycosis.
- Clinical interpretation of IgM EIA results requires caution and should be corroborated with other diagnostic methods.
- This highlights the need for improved diagnostic strategies to reduce misdiagnosis and ensure appropriate patient management for coccidioidomycosis.
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