{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T20:52:10Z","timestamp":1769979130426,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Meningitis is the most devastating form of coccidioidomycosis. A convenient, rapid diagnostic method could result in early treatment and avoid many meningitis complications. We studied cerebrospinal fluid (CSF) samples in patients with documented coccidioidal meningitis, and controls, with complement fixation (CF), immunodiffusion (ID) (the \u201cclassical\u201d assays), lateral flow assays (LFA; one-strip and two-strip), and two enzyme immunoassays (EIA). The two-strip LFA and EIAs not only enabled separate testing for IgG and IgM antibodies separately, but also could aggregate results for each method. CF with ID or the aggregate use of IgG and IgM tests were considered optimal test uses. LFAs and EIAs were evaluated at 1:21 and 1:441 dilutions of specimens. All assays were compared to true patient status. With 49 patient specimens and 40 controls, this is the largest comparative study of CSF coccidioidal diagnostics. Sensitivity of these tests ranged from 71\u201395% and specificity 90\u2013100%. IgM assays were less sensitive. Assays at 1:441 were similarly specific but less sensitive, suggesting that serial dilutions of samples could result in assays yielding titers. Agreement of positive results on cases was 87\u2013100%. When kits are available, hospital laboratories in endemic areas can perform testing. LFA assays do not require a laboratory, are simple to use, and give rapid results, potentially even at the bedside.<\/jats:p>","DOI":"10.3390\/jof6030125","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T06:02:21Z","timestamp":1596607341000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparative Study of Newer and Established Methods of Diagnosing Coccidioidal Meningitis"],"prefix":"10.3390","volume":"6","author":[{"given":"David A.","family":"Stevens","sequence":"first","affiliation":[{"name":"California Institute for Medical Research, 2260 Clove Drive, San Jose, CA 95128, USA"},{"name":"Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marife","family":"Martinez","sequence":"additional","affiliation":[{"name":"California Institute for Medical Research, 2260 Clove Drive, San Jose, CA 95128, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Sass","sequence":"additional","affiliation":[{"name":"California Institute for Medical Research, 2260 Clove Drive, San Jose, CA 95128, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demosthenes","family":"Pappagianis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of California School of Medicine, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Doherty","sequence":"additional","affiliation":[{"name":"IMMY, Inc., 2701 Corporate Center Drive, Norman, OK 73069, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Kutsche","sequence":"additional","affiliation":[{"name":"IMMY, Inc., 2701 Corporate Center Drive, Norman, OK 73069, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6506-189X","authenticated-orcid":false,"given":"Meredith","family":"McGuire","sequence":"additional","affiliation":[{"name":"IMMY, Inc., 2701 Corporate Center Drive, Norman, OK 73069, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0891-5520(02)00040-5","article-title":"Coccidioidomycosis","volume":"17","author":"Chiller","year":"2003","journal-title":"Infect. 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