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Test ID HICBL Histoplasma/Blastomyces Panel, Spinal Fluid

Specimen Required

Container/Tube: Sterile vial

Specimen Volume: 1.5 mL


If not ordering electronically, complete, print, and send a Microbiology Test Request (T732) with the specimen.

Useful For

Aiding in the diagnosis of Histoplasma meningitis


Detecting antibodies in patients having blastomycosis

Profile Information

Test ID Reporting Name Available Separately Always Performed
CHIST Histoplasma Ab, CSF Yes Yes
CBL Blastomyces Ab Immunodiffusion, CSF Yes Yes

Method Name

CHIST: Complement Fixation (CF)/Immunodiffusion

CBL: Immunodiffusion

Reporting Name

Histoplasma/Blastomyces Panel, CSF

Specimen Type


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 14 days
  Frozen  14 days

Clinical Information


Histoplasma capsulatum is a soil saprophyte that grows well in soil enriched with bird droppings. The usual disease is self-limited, affects the lungs, and is asymptomatic. Chronic cavitary pulmonary disease, disseminated disease, and meningitis may occur and can be fatal, especially in young children and immunosuppressed patients.



The dimorphic fungus, Blastomyces dermatitidis, causes blastomycosis. When the organism is inhaled, it causes pulmonary disease: cough, pain, and hemoptysis, along with fever and night sweats. It commonly spreads to the skin, bone, or internal genitalia where suppuration and granulomas are typical. Occasionally, primary cutaneous lesions after trauma are encountered; however, this type of infection is uncommon. Central nervous system disease is uncommon.

Reference Values

Histoplasma ANTIBODY

Mycelial by complement fixation: Negative

Yeast by complement fixation: Negative

Antibody by immunodiffusion: Negative






-Any positive serologic result in spinal fluid is significant.

-Simultaneous appearance of the H and M precipitin bands indicates active histoplasmosis.

-The M band alone indicates active or chronic disease or a recent skin test for histoplasmosis.



A positive result is suggestive of infection, but the results cannot distinguish between active disease and prior exposure. Furthermore, detection of antibodies in cerebrospinal fluid (CSF) may reflect intrathecal antibody production, or may occur due to passive transfer or introduction of antibodies from the blood during lumbar puncture.


Routine fungal culture of clinical specimens (eg, CSF) is recommended in cases of suspected blastomycosis involving the central nervous system.

Clinical Reference

1. Kaufman L, Kovacs JA, Reiss E: Clinical immunomycology. In: Rose NL, Conway-de Macario E, Folds JD, eds. Manual of Clinical and Laboratory Immunology. ASM Press; 1997:588-589

2. Gauthier GM, Klein BS: Blastomycosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:3177-3189

3. Deepe GS: Histoplasma capsulatum Histoplasmosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:3162-3176

Day(s) and Time(s) Performed

Monday; 6 a.m.

Tuesday through Friday; 9:30 a.m.

Analytic Time

3 day

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86698 x 3-Histoplasma Antibody, CSF

86612-Blastomyces Antibody, CSF

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HICBL Histoplasma/Blastomyces Panel, CSF 91683-3


Result ID Test Result Name Result LOINC Value
15134 Blastomyces Immunodiffusion (CSF) 51741-7
15118 Histoplasma Mycelial (CSF) 27220-3
15119 Histoplasma Yeast (CSF) 27209-6
15120 Histoplasma Immunodiffusion (CSF) 91682-5

Testing Algorithm

See Meningitis/Encephalitis Panel Algorithm in Special Instructions.