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. 2015 Mar 4;45(4):1357-61.
doi: 10.1590/s1517-83822014000400028. eCollection 2014.

Immunological assays employed for the elucidation of an histoplasmosis outbreak in São Paulo, SP

Angela Noronha Passos  1 , Valdelene Sayuri Kohara  2 , Roseli Santos de Freitas  3 , Adriana Pardini Vicentini  1
Affiliations

Immunological assays employed for the elucidation of an histoplasmosis outbreak in São Paulo, SP

Angela Noronha Passos et al. Braz J Microbiol. .

Abstract

Several reports showed outbreaks of histoplasmosis acquired while bat-inhabited caves were visited by tourists, miners or researchers. We evaluated the performance of double immunodifusion (DI) and immunoblotting (IB) assays, employed for the histoplasmosis outbreak elucidation occurred in Vale do Paraíba, São Paulo. The existence of epidemiologic link, four patients with clinical signs suggestive of histoplasmosis and mycological confirmation has made that all 35 individuals involved to the cave visit were subjected to serological evaluation. By DI, we observed reactivity against H. capsulatum antigen in a single serum examined nearly 20 days after exposure to fungal propagules. On the other hand, IB showed reactivity against H and M fractions in 50% of samples evaluated. The analysis of the second sample batch, collected two months after the exposure showed that 96.7% were reactive by DI with antibodies titers ranging from 1 to 16 and 100% of reactivity against H and M fractions, by IB, suggesting an acute infection. The analysis of the overall agreement between the methods showed to be reasonable (κ = 0.37). This study confirms the importance and efficacy of more sensitive methodologies, such as IB assay, to early elucidation of disease, especially in cases of patients without mycological information.

Keywords: Histoplasma; double immunodiffusion; histoplasmosis; immunoassay; immunoblotting.

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Figures

Figure 1
Figure 1
Representative IB reactions for H. capsulatum antigen with serum samples obtained from individuals during an outbreak of acute pulmonary histoplasmosis, ~60 days after the exposure. C+: positive control.
See this image and copyright information in PMC

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