Predictive value of serologic tests in the diagnosis and follow-up of patients with Paracoccidioidomycosis

Abstract

ABSTRACT: A serologic study was undertaken in a gtoup of 4A patients with active pe lacoscidioidomycosis who were treated in the same foÍm (ketoconazole). fo¡ identicaJ. periods of time (6 months), and followed-up for valious periods post. therapy. The tests employed w€re agar gel iÌnrnunodiffusion (.A,GID) and, com: plement fixation (FC). AIso studied were S0 seta from patients ,with proven histoplasmosis and pulmonary aspergilloma, B0 patients rwith culturaly proven tuberculosis as \¡¡¡ell as 92 specimens from healthy individuals, residents in thg endemic a.rea for pamcoccidioidornlrcosis, A single lot of yea,st filtpàte antigen wâs used throwhout the stud¡r, ltre va,lue of each tÆst was measuted acsording to GAIEN a¡rd GAMBINO 6. Both tests v¡ere highly sensi¿ive, gg aÃd. gtVo rcs. tæctively. Regarding their specificity, the AGID was totally specific S¿hile the CI' edúbited 96.6Vo and 97qo specificiþ in front of tuberculosis patients and healthy individuals respectively and. 82% in comperison ï'ith patients with other mJ¡coses. The concElt of predlctive value, that is, Ûre certainty one ha.s in accepting a positive test ås diagnostic of paracoccidioidomycosis, favored tbe ,q.GID proædure (70OVo) ov4-r the CF test. The lattet coutd sort out vnllr- 9t7o ceftainty a patient with patacoccidioidomycosis among a group of healthy indi. viduals a,nd willf, 97.5% in the sase of TB patients; when the group in question was composed by individuals with other deep Í\ycoses, sucTì certBinty was lower (877a). T'he above results indicâte that both the .4,GID and the CF iests fumish results of high sonfidenc€; one should not telay, howevel, in the CF alone as a means to establish the specific diagnosis of pamcoccidioidomycosis.