What is the role of serology testing in the workup of fungal pneumonia?

Updated: Jun 21, 2019
  • Author: Romeo A Mandanas, MD, FACP; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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The utility of serology depends on the individual fungal infectious agent. Antibody detection for the identification of C immitis is highly useful for all forms of pulmonary infection caused by this fungi. [5] Serology also plays an important role in the diagnosis of acute pulmonary and chronic cavitary pulmonary histoplasmosis. Both complement fixation and immunodiffusion tests should be ordered, [5] but these tests are of less utility if the pulmonary infection is due to other fungi.

Serology testing for blastomycosis provides little clinical diagnostic help because of the insensitivity of testing for this fungus and the antibody cross-reactivity that occurs with other fungal infections.

Patients with pulmonary sporotrichosis will have antibody against S schenckii; however, it is highly variable in sensitivity and specificity. Thus, it may not be useful in the diagnosis of the disease.

Detection of the polysaccharide capsule antigen in serum plays an important role in the diagnosis of disseminated cryptococcosis, but its sensitivity decreases in those patients not infected with human immunodeficiency virus, and also disease limited to the lung. [1]

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