Detection of Blastomyces dermatitidis antigen in patients with newly diagnosed blastomycosis

Bariola, J Ryan; Hage, Chadi A.; Durkin, Michelle; Bensadoun, Eric; Gubbins, Paul O.; Wheat, L. Joseph; Bradsher, Robert W.

doi:10.1016/j.diagmicrobio.2010.09.015

Cited by 94 publications

(69 citation statements)

References 16 publications

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“…Similar to prior reports in people and dogs,7, 8, 9, 10 we found urine Blastomyces antigen to be highly sensitive for the diagnosis of blastomycosis (100% sensitivity in this population). The sensitivity for serum antigen test was also quite high (about 90%), which is similar to previous reports (87%) 8.…”

Section: Discussionsupporting

confidence: 89%

“…In the absence of organism identification, diagnosis has been accomplished historically through a combination of clinical signs, radiographic findings, and serum antibodies 2, 4, 5, 6. Recently an antigen test has been developed, which detects a cell wall galactomannan, and has been found to have a high degree of both sensitivity and specificity for the diagnosis of blastomycosis in dogs and humans 7, 8, 9, 10. Although both urine and serum can be assayed to evaluate the presence of Blastomyces antigen, urine antigen measurement appears to have an increased sensitivity relative to serum antigen for the diagnosis of blastomycosis in dogs 8…”

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confidence: 99%

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Serum and UrineBlastomycesAntigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis

Foy

Trepanier

Kirsch³

et al. 2014

Veterinary Internal Medicne

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BackgroundSerum and urine Blastomyces antigen concentrations can be used to diagnose blastomycosis in dogs.Objectives Blastomyces antigen concentrations correlate with clinical remission in dogs during antifungal treatment, and detect disease relapse after treatment discontinuation.Animals21 dogs with newly diagnosed blastomycosis monitored until clinical remission (Treatment Phase), and 27 dogs monitored over 1 year from the time of antifungal discontinuation or until clinical relapse (After Treatment Phase).MethodsProspective study. Dogs were monitored monthly during treatment and every 3 months after treatment discontinuation, with a complete history, physical exam, chest radiographs, and ocular exam. Urine and serum Blastomyces antigen concentrations were measured at each visit using a quantitative enzyme immunoassay.ResultsAt enrollment in the Treatment Phase, Blastomyces antigen was positive in all 21 urine samples (100% sensitivity; 95% CI 85–100%), and in 18 of 20 serum samples (90% sensitivity; 95% CI 70–97%). At 2–4 months of treatment, urine antigen was more sensitive for clinically detectable disease (82%; CI 60–94%) than serum antigen (18%; CI 6–41%). The sensitivity of the urine test for clinical relapse was 71% (CI 36–92%), with close to 100% specificity (CI 84–100%) during after treatment surveillance in this population.ConclusionsUrine Blastomyces antigen testing has high sensitivity for active disease at the time of diagnosis and during treatment, and moderate sensitivity but high specificity for clinical relapse. Urine testing should be useful at the time of diagnosis, when treatment discontinuation is being considered, and anytime there is poor clinical response or suspicion of relapse.

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Section: Discussionsupporting

confidence: 89%

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confidence: 99%

Serum and UrineBlastomycesAntigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis

Foy

Trepanier

Kirsch³

et al. 2014

Veterinary Internal Medicne

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“…The primary objective of this present study was to compare different antibody-antigen combinations for the detection of antigen in urine specimens from dogs with diagnosed blastomycosis. Several recent studies have focused on antigen detection in blastomycosis in humans and dogs [7,15,16]. In one study, detectable antigenuria was achieved in approximately 85% of the subjects with newly diagnosed blastomycosis, but B. dermatitidis antigen was also detected in 15 patients with histoplasmosis [15].…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies have focused on antigen detection in blastomycosis in humans and dogs [7,15,16]. In one study, detectable antigenuria was achieved in approximately 85% of the subjects with newly diagnosed blastomycosis, but B. dermatitidis antigen was also detected in 15 patients with histoplasmosis [15]. In another human subject study, antigenuria was detected in approximately 90% of patients with proven blastomycosis.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years other investigators have been approaching the problem of immunodiagnosis and have produced encouraging results with antigen detection assays as second-generation assays have been developed [7,[14][15][16][17][18]. Our laboratory has been focusing on the use of the competitive enzyme-linked immunosorbent assay (ELISA) in B. dermatitidis antigen detection studies in urine specimens from dogs with diagnosed blastomycosis [11].…”

Section: Introductionmentioning

confidence: 99%

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Antigen Detection in Canine Blastomycosis: Comparison of Different Antibody-Antigen Combinations in Two Competitive ELISAs

Andrae

Birch²,

Bybee³

et al. 2012

OJMM

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This present study was designed to evaluate four different Blastomyces dermatitidis antibody-antigen combinations (B5896 and T-58 antibodies and B5896 and WI-R antigens) for the detection of antigen in 36 urine specimens from dogs with blastomycosis using a standard indirect ELISA (STD) and a biotin-streptavidin ELISA (B-SA). The antigen detection sensitivity values ranged from 81% (B-SA: T-58 Ab + WI-R Ag) to 100% (STD and B-SA: B5896 Ab + WI-R Ag; B5896 Ab + B5896 Ag) with the antibody-antigen combinations in the two assays. Optimal detection was evidenced when the B5896 Ab was allowed to react with the urine specimens for 30 min at 37˚C and then placed in the B-SA ELISA plates containing the B5896 Ag. The greatest absorbance value obtained with this antibody-antigen combination was 0.903 (range of 0.596 -0.903) as compared to the control value of 1.246. The difference between the control absorbance and the test absorbance values was 0.343 which was considerably greater than the control-test values with the other combinations. This study thus showed that the results obtained in antigen detection assays are dependent upon the antibody used to react with the urine specimens as well as the antigen used in the enzyme immunoassay.

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Pathology Quiz Case 2: Diagnosis

2012

Arch Otolaryngol Head Neck Surg

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Detection of Blastomyces dermatitidis antigen in patients with newly diagnosed blastomycosis

Cited by 94 publications

References 16 publications

Serum and UrineBlastomycesAntigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis

Serum and UrineBlastomycesAntigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis

Antigen Detection in Canine Blastomycosis: Comparison of Different Antibody-Antigen Combinations in Two Competitive ELISAs

Pathology Quiz Case 2: Diagnosis

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