MEDICAL MYCOLOGY

Dr Tadayo Hashimoto M.D.
Professor
Department of Microbiology & Immunology

19. A female patient who participated in an archeological excavation of Indian ruins in the southwestern region of the United States complains of severe systemic and respiratory symptoms. Her skin coccidioidin test is positive. The titers of complement-fixing antibody are as follows:
Day 15 after exposure 1 : 8
Day 21 after exposure 1 : 16
Day 28 after exposure 1 : 64

You may predict that she:

will recover soon because high complement fixation does not correlate with the severity of infection
may have active disseminated coccidioidomycosis
can be released soon because high levels found in the complement fixation test mean high immunity
may not need amphotericin B treatment
none of the above

(B) The complement fixation (CF) test for antibodies (IgG) to coccidioidin is a powerful diagnostic and prognostic tool. Because the CF test becomes positive more slowly and persists longer, the presence of CF antibodies may reflect either active infection or the recovery stage. In coccidioidomycosis, the CF titer correlates with the severity of disease. A critical titer of 1 : 32 or higher reflects active disseminated disease, because many patients, such as those with single extra pulmonary lesions, do not develop high titers. (Joklik et al, p. 1096; Ryan et al, pp. 610-611)

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Last Reviewed: Feb 11, 2009
Created: Aug 9, 1996