脑膜炎是球孢子菌病最具破坏性的形式。一个方便的，快速诊断方法可以早期治疗，避免许多脑膜炎并发症。我们研究了有记载的球虫病患者的脑脊液（CSF）样本，和控制，具有补体固定（CF），免疫扩散(ID)(“经典”试验)，侧流测定（LFA；一条和两条），和两种酶免疫测定(EIA)。两条式LFA和EIA不仅能够分别检测IgG和IgM抗体，但也可以汇总每种方法的结果。具有ID的CF或IgG和IgM测试的总体使用被认为是最佳测试用途。在样品的1:21和1:441稀释度下评价LFA和EIA。将所有测定与真实患者状态进行比较。有49个病人标本和40个对照,这是CSF球虫诊断的最大比较研究.这些测试的灵敏度范围为71-95％，特异性为90-100％。IgM测定敏感性较低。在1:441的测定具有类似的特异性，但敏感性较低，表明样品的连续稀释可能导致产生滴度的测定。病例阳性结果的一致性为87-100%。当套件可用时，流行地区的医院实验室可以进行测试。LFA检测不需要实验室，使用简单，并给出快速的结果，甚至可能在床边。
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 \"classical\" 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 71-95% and specificity 90-100%. 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 87-100%. 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.
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