Serology of paracoccidioidomycosis

Abstract

This review provides the background for understanding the role of a battery of diagnostic methods in paracoccidioidomycosis (PCM). This systemic mycosis is a disease endemic in many regions of Latin America, with sporadic cases also occurring throughout the world (mycosis of importation). Although excellent laboratory methods for diagnosis are available, there are deficiencies that must be met by continued research. Understanding the uses and limitations of a battery of laboratory methods is essential to diagnose PCM. Clinicians and laboratory directors must be familiar with the uses and limitations of a battery of serologic and mycological tests to accurately diagnose of PCM. Antibody and antigen detections are valuable adjuncts to histopathology and culture. More recently, the gp43 and gp70 antigen detection assay have improved the methodology of diagnosis of this mycosis, which improves reproducibility and facilitates monitoring antigen clearance during antifungal treatment. Furthermore, detection of antigen in cerebrospinal fluid and in bronchoalveolar lavage fluid increases the sensitivity for diagnosis of PCM in central nervous system and in pulmonary infections, respectively.

Serological diagnosis of paracoccidioidomycosis in HIV-coinfected patients

“…In a series of coinfected patients in which a small number of patients were assessed with serological tests for anti-P. brasiliensis antibodies, false-negative results were obtained in 33% (Paniago et al 2005) and 66% (Marques et al 1995) of the serum samples. The use of CIEP or ELISA increased the rate of reactive sera; however, in both tests the low levels of anti-P. brasiliensis in some HIV-infected patients were insufficient for a safe serological diagnosis of paracoccidioidomycosis because of cross-reactions and specificity lower than 100% (de Camargo 2008). In this investigation, the joint use of two serological tests increased to 100% the positivity of detection of P. brasiliensis antibodies (data not shown).…”

Paracoccidioides brasiliensis infection in dogs from Western Brazilian Amazon

“…The immunodiffusion with exoantigen is the test of choice for diagnosis of paracoccidioidomycosis in humans (Camargo 2008). The lack of reactivity observed in the immunodiffusion test probably is due its lower sensitivity when compared with ELISA and suggests that dogs were infected by P. brasiliensis but without disease as observed in other seroepidemiological studies (Ono et al 2001, Fontana et al 2010.…”

Paracoccidioidomicosis juvenil diseminada diagnosticada en una niña en área urbana

“…En más de 90 % de los casos, la visualización directa del hongo suele lograse con el examen en fresco con hidróxido de potasio (KOH) (11,22).…”

“…Las pruebas serológicas también pueden emplearse en el diagnóstico, pero su importancia principal radica en el seguimiento de la respuesta al tratamiento instaurado (22). Entre las pruebas serológicas usadas están la doble inmunodifusión en gel de agar, la inmunofluorescencia indirecta (IFI) y las pruebas ELISA y de inmunotransferencia, las cuales muestran sensibilidades de entre 85 y 100 %.…”