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Test ID TULM Francisella tularensis Antibody, IgM, ELISA, Serum


Specimen Required


Only orderable as part of a profile. For more information see Francisella tularensis Antibody, IgM and IgG, ELISA, Serum.

 

Supplies: Aliquot Tube, 5 mL (T465)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.6 mL

Collection Instructions: Centrifuge and aliquot serum.


Useful For

Aiding in the diagnosis of tularemia caused by Francisella tularensis using IgM antibody testing

 

This assay should not be used as a test of cure as it is not quantitative and patients may remain seropositive for months to years following resolution of disease.

Method Name

Only orderable as part of a profile. For more information see Francisella tularensis Antibody, IgM and IgG, ELISA, Serum.

 

Enzyme-Linked Immunosorbent Assay (ELISA)

Reporting Name

F. tularensis Ab, IgM ELISA, S

Specimen Type

Serum

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  30 days

Clinical Information

Francisella tularensis is a small, intracellular, coccobacillary Gram negative bacterium and is an obligate pathogen in animals and humans, primarily maintained in rabbits, hares, cats, ticks and deerflies. F tularensis is found throughout North America and parts of Asia, and similar to Brucella species is considered a potential agent of bioterrorism. Human infection with F tularensis usually occurs through inhalation of infected aerosols, ingestion of contaminated meat or water, handling of diseased or sick animals, or through the bite of an infected arthropod (eg, tick, deerflies).

 

Following a 3 to 5 day incubation period, the clinical manifestations of infection with F tularensis differ primarily depending on the site and route of infection. The most common form of disease is ulceroglandular (45%-80% of cases), which is associated with an arthropod (or animal) bite or another cause of skin barrier compromise. This leads to development of a painful papule which ultimately ulcerates following which the bacterium enters the lymphatic system. Glandular tularemia is similar in presentation to ulceroglandular disease, however it lacks the ulceration and more frequently causes septicemia. Other, less frequent clinical manifestations include oculoglandular (Parinaud syndrome), oropharyngeal and gastrointestinal disease, pneumonic or typhoidal tularemia.

 

Diagnostic testing options for F tularensis primarily include culture and serology. Physicians suspecting tularemia should collect appropriate specimens (eg, skin lesion biopsy, lymph node aspirates, etc.) promptly and send for culture. The microbiology laboratory should be alerted to the possibility of F tularensis to ensure that appropriate safety measures are taken to protect the laboratory technologists. Growth on culture is a definitive means of making a diagnosis of tularensis. Serologic testing may be used to support a diagnosis of current or recent tularensis in patients who are IgM positive, or seroconvert to IgM, or IgG positive in paired sera collected 2 to 3 weeks apart.

Reference Values

Only orderable as part of a profile. For more information see Francisella tularensis Antibody, IgM and IgG, ELISA, Serum.

 

Negative

Reference values apply to all ages.

Interpretation

IgM Result

IgG Result

Interpretation

Negative

Negative

No antibodies to Francisella tularensis detected. Antibody response may be negative in samples collected too soon following infection/exposure. Repeat testing on a new sample if clinically indicated.

Positive

Negative

IgM class antibodies to F tularensis detected, suggesting current or recent infection. Repeat testing in 2 to 3 weeks to detect seroconversion of IgG may be considered to confirm the diagnosis.

Positive

Borderline

Borderline

Negative

Questionable presence of IgM antibodies to F tularensis. Consider repeat testing in 1 to 2 weeks.

Borderline

Positive

IgG class antibodies to F tularensis detected suggesting recent or past infection. Clinical correlation alongside presentation, exposure history and other laboratory findings required.

Borderline

Borderline

Questionable presence of IgM and IgG class antibodies to F tularensis. Consider repeat testing in 1 to 2 weeks.

Positive

Positive

IgM and IgG class antibodies to F tularensis detected suggesting current, recent or past infection. Clinical correlation alongside presentation, exposure history and other laboratory findings required.

Negative

Positive

IgG class antibodies to F tularensis detected suggesting recent or past infection. Clinical correlation alongside presentation, exposure history and other laboratory findings required.

Negative

Borderline

Questionable presence of IgG antibodies to F tularensis. Consider repeat testing in 1 to 2 weeks.

Clinical Reference

1. Petersen JM, Schriefer ME, Araj GE: Francisella and Brucella. In Manual of Clinical Microbiology. 12th Edition. 2019

2. Nigrovic LE, Wingerter SL: Tularemia. Infect Dis Clin North Am. 2008; 22(3): 489-504. doi: 10.1016/j.idc.2008.03.004

Day(s) and Time(s) Performed

Tuesday and Thursday; 2 p.m.

Analytic Time

Same day/1 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

86668

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TULM F. tularensis Ab, IgM ELISA, S 93716-9

 

Result ID Test Result Name Result LOINC Value
TULM F. tularensis Ab, IgM ELISA, S 93716-9