Home
HelpTest ID HICBL Histoplasma/Blastomyces Panel, Spinal Fluid
Specimen Required
Container/Tube: Sterile vial
Specimen Volume: 1.5 mL
Forms
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, CSFSpecimen Type
CSFSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| CSF | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Clinical Information
Histoplasma
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.
Blastomyces
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
Blastomyces ANTIBODY IMMUNODIFFUSION
Negative
Interpretation
Histoplasma:
-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.
Blastomyces:
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 dayTest 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.