Document 0118
 DOCN  M9650118
 TI    Cerebrospinal fluid antibodies detected by ELISA against a 33-kDa
       antigen from spherules of Coccidioides immitis in patients with
       coccidioidal meningitis. The National Institute of Allergy and
       Infectious Diseases Mycoses Study Group.
 DT    9605
 AU    Galgiani JN; Peng T; Lewis ML; Cloud GA; Pappagianis D; Medical Service,
       VA Medical Center, Tucson, AZ 85723, USA.
 SO    J Infect Dis. 1996 Feb;173(2):499-502. Unique Identifier : AIDSLINE
       MED/96162119
 AB    Antibodies against a 33-kDa antigen from Coccidioides immitis were
       detected by ELISA in patients' cerebrospinal fluid (CSF). Anti-33-kDa
       antibodies were detected at dilutions > 1:80 in only 1 (1.4%) of 73
       patients without coccidioidal meningitis but in 74 (71.8%) of 103 with
       meningitis. Anti-33-kDa antibodies were detected in 53 (91.4%) of 58
       patients whose anti-coccidioidal complement-fixing (CF) antibodies were
       detectable and in 21 (46.7%) of 45 patients whose CSF was negative by CF
       test (positive predictive value, 99%; negative predictive value, 71%;
       sensitivity, 72%; specificity, 99%). Anti-33-kDa antibodies, among which
       IgG1 was the dominant subclass, increased when infections worsened and
       decreased when patients' conditions improved. Antibody concentration
       appeared to be independent of most baseline findings, although only 1 of
       5 patients coinfected with human immunodeficiency virus had initially
       detectable antibodies. Measurement of anti-33-kDa antibodies is a
       sensitive indicator of coccidioidal meningitis and of its clinical
       course.
 DE    Antibodies, Fungal/*CEREBROSPINAL FLUID  Antifungal Agents/THERAPEUTIC
       USE  Antigens, Fungal/*IMMUNOLOGY  Coccidioides/*IMMUNOLOGY
       Coccidioidomycosis/*CEREBROSPINAL FLUID/DIAGNOSIS/DRUG THERAPY
       Complement Fixation Tests  Enzyme-Linked Immunosorbent Assay/*METHODS
       Fluconazole/THERAPEUTIC USE  Human  IgG/ANALYSIS  Meningitis,
       Fungal/*CEREBROSPINAL FLUID/DIAGNOSIS/DRUG THERAPY  Molecular Weight
       Sensitivity and Specificity  Support, Non-U.S. Gov't  Support, U.S.
       Gov't, Non-P.H.S.  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).