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The diagnosis of blastomycosis is challenging because it mimics infectious and non-infectious diseases. Blastomyces adhesin-1 (BAD-1) protein is a major virulence factor in B. dermatitidis and B. gilchristii and induces a humoral immune response during infection. The goal of this retrospective, case-control study conducted at the University of Wisconsin\u2013Madison is to investigate the test characteristics of the newly developed second generation BAD-1 IgG Enzyme Immunoassay (EIA) antibody test for the diagnosis of blastomycosis. The study was performed in an endemic area in a diverse patient population including persons with underlying immunocompromise. Thirty-six case patients with proven or probable blastomycosis were compared to 370 controls. Serum BAD-1 IgG was positive in 50% of the case patients and in 9.7% of the controls, which resulted in a sensitivity of 50% and specificity of 90.2%. The highest sensitivity (80%) occurred in non-immunocompromised persons with chronic blastomycosis and the lowest sensitivity occurred in those with acute blastomycosis (35.0%) or immunocompromise (37.5%). Sensitivity was not influenced by dissemination or severity of disease. In conclusion, this study demonstrates that the BAD-1 IgG EIA can serve as adjunctive test for the diagnosis of blastomycosis in select patient populations living in regions endemic for blastomycosis.<\/jats:p>","DOI":"10.1093\/mmy\/myag002","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:38:23Z","timestamp":1768567103000},"source":"Crossref","is-referenced-by-count":0,"title":["Role of\n                    <i>Blastomyces<\/i>\n                    BAD-1 IgG Enzyme Immunoassay (EIA) for the diagnosis of blastomycosis in persons residing in an endemic area"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-0536","authenticated-orcid":false,"given":"Gregory M","family":"Gauthier","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of Wisconsin School of Medicine & Public Health, University of Wisconsin\u2013Madison , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauzia","family":"Hollnagel","sequence":"additional","affiliation":[{"name":"University of Wisconsin School of Medicine & Public Health, University of Wisconsin\u2013Madison , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Klein","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Wisconsin School of Medicine & Public Health, University of Wisconsin\u2013Madison , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Sterkel","sequence":"additional","affiliation":[{"name":"University of Wisconsin\u2013Madison Department of Pathology and Laboratory Medicine, , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noveroske","family":"Shanna","sequence":"additional","affiliation":[{"name":"Miravista Diagnostics , Indianapolis, Indiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Wheat","sequence":"additional","affiliation":[{"name":"Miravista Diagnostics , Indianapolis, Indiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"issue":"3","key":"2026072401364650700_bib1","doi-asserted-by":"crossref","first-page":"e59237","DOI":"10.1371\/journal.pone.0059237","article-title":"Phylogenetic analysis reveals a cryptic species of Blastomyces gilchristii, sp. 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