Test ID: CHIST
Histoplasma Antibody, Spinal Fluid
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of Histoplasma meningitis
Method Name A short description of the method used to perform the test
Complement Fixation (CF)/Immunodiffusion
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross OK |
| Lipemia | Mild OK; Gross OK |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| CSF | Refrigerated (preferred) | 14 days |
| Frozen | 14 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Mycelial by CF: negative (positives reported as titer)
Yeast by CF: negative (positives reported as titer)
Antibody by immunodiffusion: negative (positives reported as band present)
Interpretation Provides information to assist in interpretation of the test results
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.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Antibody levels may be low in spinal fluid in cases of Histoplasma meningitis.
Histoplasmin skin tests yield specific antibodies in titratable quantity, and may cause difficulties in interpretation.
Cross-reacting antibodies with coccidioidomycosis or blastomycosis may cause false-positive results for Histoplasmosis.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Kaufman L, Kovacs JA, Reiss E: Clinical immunomycology. In Manual of Clinical and Laboratory Immunology, Washington, DC, ASM Press.1997
Method Description Describes how the test is performed and provides a method-specific reference
Both immunodiffusion and compliment fixation (CF) tests are used to detect antibodies to Histoplasma capsulatum. For immunodiffusion, the antigen is a culture filtrate, histoplasmin. H and M precipitin bands are identified. For the CF test, the antigens are histoplasmin and a yeast form of Histoplasma capsulatum; the latter is more sensitive. (Roberts GD: Fungi. In Laboratory Procedures in Clinical Microbiology. 2nd edition. Edited by JA Washington II. New York, Springer-Verlag, 1985)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday, 9:30 a.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86698 x 3
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 15118 | Histoplasma Mycelial (CSF) | 12456-0 |
| 15119 | Histoplasma Yeast (CSF) | 12455-2 |
| 15120 | Histoplasma Immunodiffusion (CSF) | 21330-6 |
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