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. 1986 Mar;23(3):493–499. doi: 10.1128/jcm.23.3.493-499.1986

Evaluation of cross-reactions in Histoplasma capsulatum serologic tests.

J Wheat, M L French, S Kamel, R P Tewari
PMCID: PMC268681  PMID: 2420821

Abstract

Cross-reactivity in Histoplasma serologic tests was evaluated by using sera from patients with histoplasmosis and other infections. Serum samples from 127 of 134 (95%) patients with histoplasmosis were judged positive by complement fixation tests, and 121 (90%) showed H bands, M bands, or both by immunodiffusion. Of these 134 patients, cross-reactions were seen to Blastomyces dermatitidis in 53 patients (40%), to Coccidioides immitis in 20 patients (16%), and to Aspergillus fumigatus in 3 patients (2%) by complement fixation. Serum samples from 5 of 99 patients (5%) with other fungal infections and from 5 of 46 patients (11%) with tuberculosis had M precipitin bands by the Histoplasma immunodiffusion test, whereas none of the 123 sera from patients with other bacterial, Mycoplasma, or viral infections showed H or M precipitin bands. In the complement fixation test, positive reactions were observed in 16 of 90 patients (18%) with other fungal infections, in 14 of 41 patients (34%) with tuberculosis, and in 18 of 105 patients (17%) with other bacterial, Mycoplasma, or viral infections. Positive reactions were seen by radioimmunoassay in 54 of 110 patients (49%) with other fungal infections, in 23 of 46 patients (50%) with tuberculosis, and in 35 of 123 patients (28%) with with other bacterial, Mycoplasma, or viral infections. These results demonstrate a wider range of cross-reactions in Histoplasma serology than has been previously recognized, and the cross-reactivity was greatest when observed by radioimmunoassay. Caution should be exercised in the interpretation of serologic data from patients with suspected fungal infections.

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Selected References

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  1. Aufman L. Serology of systemic fungus diseases. Public Health Rep. 1966 Feb;81(2):177–185. [PMC free article] [PubMed] [Google Scholar]
  2. Axelsen N. H. Analysis of human Candida precipitins by quantitative immunoelectrophoresis: a model for analysis of complex microbial antigen-antibody systems. Scand J Immunol. 1976;5(3):177–190. doi: 10.1111/j.1365-3083.1976.tb00268.x. [DOI] [PubMed] [Google Scholar]
  3. Azuma I., Kanetsuna F., Tanaka Y., Yamamura Y., Carbonell L. M. Chemical and immunological properties of galactomannans obtained from Histoplasma duboisii, Histoplasma capsulatum, Paracoccidioides brasiliensis and Blasomyces dermatitidis. Mycopathol Mycol Appl. 1974 Oct 15;54(1):111–125. doi: 10.1007/BF02055979. [DOI] [PubMed] [Google Scholar]
  4. Bindschadler D. D., Bennett J. E. Serology of human cryptococcosis. Ann Intern Med. 1968 Jul;69(1):45–52. doi: 10.7326/0003-4819-69-1-45. [DOI] [PubMed] [Google Scholar]
  5. CAMPBELL C. C., BINKLEY G. E. Serologic diagnosis with respect to histoplasmosis, coccidioidomycosis, and blastomycosis and the problem of cross reactions. J Lab Clin Med. 1953 Dec;42(6):896–906. [PubMed] [Google Scholar]
  6. Chaparas S. D., Sheagren J. N., DeMeo A., Hedrick S. Correlation of human skin reactivity with lymphocyte transformation induced by mycobacterial antigens and histoplasmin. Am Rev Respir Dis. 1970 Jan;101(1):67–73. doi: 10.1164/arrd.1970.101.1.67. [DOI] [PubMed] [Google Scholar]
  7. Daniel T. M., Janicki B. W. Mycobacterial antigens: a review of their isolation, chemistry, and immunological properties. Microbiol Rev. 1978 Mar;42(1):84–113. doi: 10.1128/mr.42.1.84-113.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Drutz D. J., Catanzaro A. Coccidioidomycosis. Part I. Am Rev Respir Dis. 1978 Mar;117(3):559–585. doi: 10.1164/arrd.1978.117.3.559. [DOI] [PubMed] [Google Scholar]
  9. Ellner J. J., Daniel T. M. Immunosuppression by mycobacterial arabinomannan. Clin Exp Immunol. 1979 Feb;35(2):250–257. [PMC free article] [PubMed] [Google Scholar]
  10. FURCOLOW M. L., SCHUBERT J., TOSH F. E., DOTO I. L., LYNCH H. J., Jr Serologic evidence of histoplasmosis in sanatoriums in the U.S. JAMA. 1962 Apr 14;180:109–114. doi: 10.1001/jama.1962.03050150015003. [DOI] [PubMed] [Google Scholar]
  11. George R. B., Lambert R. S., Bruce M. J., Pickering J. W., Wolcott R. M. Radioimmunoassay: a sensitive screening test for histoplasmosis and blastomycosis. Am Rev Respir Dis. 1981 Oct;124(4):407–410. doi: 10.1164/arrd.1981.124.4.407. [DOI] [PubMed] [Google Scholar]
  12. Graybill J. R., Alford R. H. Variability of sequential studies of lymphocyte blastogenesis in normal adults. Clin Exp Immunol. 1976 Jul;25(1):28–35. [PMC free article] [PubMed] [Google Scholar]
  13. Guinet R. M., Gabriel S. M. Candida albicans group A-specific soluble antigens demonstrated by quantitative immunoelectrophoresis. Infect Immun. 1980 Sep;29(3):853–858. doi: 10.1128/iai.29.3.853-858.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. HEINER D. C. Diagnosis of histoplasmosis using precipitin reactions in agargel. Pediatrics. 1958 Oct;22(4 Pt 1):616–627. [PubMed] [Google Scholar]
  15. Hermans P. E., Markowitz H. Serum antibody activity in patients with histoplasmosis as measured by passive hemagglutination. J Lab Clin Med. 1969 Sep;74(3):453–463. [PubMed] [Google Scholar]
  16. Huppert M., Adler J. P., Rice E. H., Sun S. H. Common antigens among systemic disease fungi analyzed by two-dimensional immunoelectrophoresis. Infect Immun. 1979 Feb;23(2):479–485. doi: 10.1128/iai.23.2.479-485.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Huppert M., Spratt N. S., Vukovich K. R., Sun S. H., Rice E. H. Antigenic analysis of coccidioidin and spherulin determined by two-dimensional immunoelectrophoresis. Infect Immun. 1978 May;20(2):541–551. doi: 10.1128/iai.20.2.541-551.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Jones J. M. Quantitation of antibody against cell wall mannan and a major cytoplasmic antigen of Candida in rabbits, mice, and humans. Infect Immun. 1980 Oct;30(1):78–89. doi: 10.1128/iai.30.1.78-89.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Kanetsuna F., Carbonell L. M., Gil F., Azuma I. Chemical and ultrastructural studies on the cell walls of the yeastlike and mycelial forms of Histoplasma capsulatum. Mycopathol Mycol Appl. 1974 Oct 15;54(1):1–13. doi: 10.1007/BF02055967. [DOI] [PubMed] [Google Scholar]
  20. Kaplan M. H., Chase M. W. Antibodies to mycobacteria in human tuberculosis. I. Development of antibodies before and after antimicrobial therapy. J Infect Dis. 1980 Dec;142(6):825–834. doi: 10.1093/infdis/142.6.825. [DOI] [PubMed] [Google Scholar]
  21. Kaufman L., Clark M. J. Value of the concomitant use of complement fixation and immunodiffusion tests in the diagnosis of coccidioidomycosis. Appl Microbiol. 1974 Oct;28(4):641–643. doi: 10.1128/am.28.4.641-643.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Kaufman L., McLaughlin D. W., Clark M. J., Blumer S. Specific immunodiffusion test for blastomycosis. Appl Microbiol. 1973 Sep;26(3):244–247. doi: 10.1128/am.26.3.244-247.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Kim S. J., Chaparas S. D. Characterization of antigens from Aspergillus fumigatus. I. Preparation of antigens from organisms grown in completely synthetic medium. Am Rev Respir Dis. 1978 Sep;118(3):547–551. doi: 10.1164/arrd.1978.118.3.547. [DOI] [PubMed] [Google Scholar]
  24. Kleger B., Kaufman L. Detection and identification of diagnostic Histoplasma capsulatum precipitates by counterelectrophoresis. Appl Microbiol. 1973 Sep;26(3):231–238. doi: 10.1128/am.26.3.231-238.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Land G. A., Foxworth J. H., Smith K. E. Immunodiagnosis of histoplasmosis in a compromised host. J Clin Microbiol. 1978 Nov;8(5):558–565. doi: 10.1128/jcm.8.5.558-565.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Lowell J. R., Shuford E. H. The value of the skin test and complement fixation test in the diagnosis of chronic pulmonary histoplasmosis. Am Rev Respir Dis. 1976 Dec;114(6):1069–1075. doi: 10.1164/arrd.1976.114.6.1069. [DOI] [PubMed] [Google Scholar]
  27. MAYS E. E., HAWKINS J. A., KUHN L. R. THE CLINICAL USEFULNESS OF FUNGAL SEROLOGIC TESTING. Dis Chest. 1964 Aug;46:205–210. doi: 10.1378/chest.46.2.205. [DOI] [PubMed] [Google Scholar]
  28. Maekawa S., Ohara T. On the existence of cross-reactive antigens between Candida and Mycobacterium. Jpn J Microbiol. 1966 Apr;10(1):1–11. doi: 10.1111/j.1348-0421.1966.tb00286.x. [DOI] [PubMed] [Google Scholar]
  29. Misaki A., Yukawa S., Tsuchiya K., Yamasaki T. Studies on cell walls of Mycobacteria. I. Chemical and biological properties of the cell walls and the mucopeptide of BCG. J Biochem. 1966 Apr;59(4):388–396. doi: 10.1093/oxfordjournals.jbchem.a128314. [DOI] [PubMed] [Google Scholar]
  30. NICHOLAS W. M., WIER J. A., KUHN L. R., CAMPBELL C. C., NOLTE L. B., HILL G. B. Serologic effects of histoplasmin skin testing. Am Rev Respir Dis. 1961 Feb;83:276–279. doi: 10.1164/arrd.1961.83.2P1.276. [DOI] [PubMed] [Google Scholar]
  31. Penn R. L., Lambert R. S., George R. B. Invasive fungal infections. The use of serologic tests in diagnosis and management. Arch Intern Med. 1983 Jun;143(6):1215–1220. doi: 10.1001/archinte.143.6.1215. [DOI] [PubMed] [Google Scholar]
  32. Pine L., Malcolm G. B., Gross H., Gray S. B. Evaluation of purified H and M antigens of histoplasmin as reagents in the complement fixation test. Sabouraudia. 1978 Dec;16(4):257–269. doi: 10.1080/00362177885380361. [DOI] [PubMed] [Google Scholar]
  33. Reeves M. W., Pine L., Bradley G. Characterization and evaluation of a soluble antigen complex prepared from the yeast phase of Histoplasma capsulatum. Infect Immun. 1974 Jun;9(6):1033–1044. doi: 10.1128/iai.9.6.1033-1044.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Reiss E., Hutchinson H., Pine L., Ziegler D. W., Kaufman L. Solid-phase competitive-binding radioimmunoassay for detecting antibody to the M antigen of histoplasmin. J Clin Microbiol. 1977 Dec;6(6):598–604. doi: 10.1128/jcm.6.6.598-604.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Restrepo A., Moncada L. H. Characterization of the precipitin bands detected in the immunodiffusion test for paracoccidioidomycosis. Appl Microbiol. 1974 Jul;28(1):138–144. doi: 10.1128/am.28.1.138-144.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Reyes-Montes M. R., Martínez A., Toriello C., Taylor M. L. Antigens from Histoplasma capsulatum and Blastomyces dermatitidis. I. Immunological comparative studies from polysaccharide-protein complexes of both fungi. Mycopathologia. 1982 Apr 23;78(1):17–23. doi: 10.1007/BF00436577. [DOI] [PubMed] [Google Scholar]
  37. San-Blas G. The cell wall of fungal human pathogens: its possible role in host-parasite relationships. Mycopathologia. 1982 Sep 17;79(3):159–184. doi: 10.1007/BF01837196. [DOI] [PubMed] [Google Scholar]
  38. Sarosi G. A., Davies S. F. Blastomycosis. Am Rev Respir Dis. 1979 Oct;120(4):911–938. doi: 10.1164/arrd.1979.120.4.911. [DOI] [PubMed] [Google Scholar]
  39. Sathapatayavongs B., Batteiger B. E., Wheat J., Slama T. G., Wass J. L. Clinical and laboratory features of disseminated histoplasmosis during two large urban outbreaks. Medicine (Baltimore) 1983 Sep;62(5):263–270. doi: 10.1097/00005792-198309000-00001. [DOI] [PubMed] [Google Scholar]
  40. Wheat J., French M. L., Kohler R. B., Zimmerman S. E., Smith W. R., Norton J. A., Eitzen H. E., Smith C. D., Slama T. G. The diagnostic laboratory tests for histoplasmosis: analysis of experience in a large urban outbreak. Ann Intern Med. 1982 Nov;97(5):680–685. doi: 10.7326/0003-4819-97-5-680. [DOI] [PubMed] [Google Scholar]
  41. Wheat L. J., Kohler R. B., French M. L., Garten M., Kleiman M., Zimmerman S. E., Schlech W., Ho J., White A., Brahmi Z. Immunoglobulin M and G histoplasmal antibody response in histoplasmosis. Am Rev Respir Dis. 1983 Jul;128(1):65–70. doi: 10.1164/arrd.1983.128.1.65. [DOI] [PubMed] [Google Scholar]
  42. Wheat L. J., Slama T. G., Eitzen H. E., Kohler R. B., French M. L., Biesecker J. L. A large urban outbreak of histoplasmosis: clinical features. Ann Intern Med. 1981 Mar;94(3):331–337. doi: 10.7326/0003-4819-94-3-331. [DOI] [PubMed] [Google Scholar]

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