CSF coccidioides complement fixation
CSF coccidioides complement fixation is a test that check for infection due to the fungus Coccidioides immitis in the cerebrospinal (CSF) fluid. This is the fluid surrounding the brain and spine.
Coccidioides antibody test - spinal fluid
How the Test is Performed
A sample of spinal fluid is needed for this test. The sample is usually obtained by lumbar puncture (spinal tap).
The sample is sent to a laboratory where it is examined for Coccidiodes antibodies using a laboratory method called complement
fixation. This technique checks if your body has produced substances called antibodies to a specific foreign substance (antigen), in this case Coccidioides immitis. Antibodies defend your body against bacteria, viruses, and fungi. If the antibodies are present, they stick, or "fix" themselves, to the antigen. This is why the test is called "fixation."
How to Prepare for the Test
A consent form must be signed. Expect to remain in the hospital for several hours afterward.
How the Test Will Feel
There are different ways to get a sample of CSF. Lumbar puncture (spinal tap) is the most common method. During the test:
- You lie on your side with knees pulled up toward your chest and chin tucked downward. Or, you sit up, but bent forward.
- After your back is cleaned, the doctor injects a local numbing medicine (anesthetic) into your lower spine.
- A spinal needle is inserted, usually into the lower back area.
- Once the needle is properly positioned, CSF pressure is measured and a sample is collected.
- The needle is removed, the area is cleaned, and a bandage is placed over the needle site.
- You are taken to a recovery area where you rest for several hours to prevent any CSF leakage.
Why the Test is Performed
Complement fixation is one of several tests for the fungus Coccidioides immitis.
The absence of fungus (a negative test) is normal.
What Abnormal Results Mean
If the test is positive for fungus, there may be an active infection in the central nervous system.
Risks of lumbar puncture include:
- Bleeding into the spinal canal
- Discomfort during the test
- Headache after the test
- Hypersensitivity (allergic) reaction to the anesthetic
- Infection introduced by the needle going through the skin
- Damage to the nerves in the spinal cord, especially if the person moves during the test
In some cases, this test may be done as a blood test
During the early stage of an illness, few antibodies may be detected. Antibody production increases during the course of an infection. For this reason, this test may be repeated several weeks after the first test.
An abnormal spinal fluid test means that the central nervous system is infected. But an abnormal blood test does not pinpoint the exact area of infection. It only means that there is a coccidioides infection somewhere in the body.
Galgiani JN. Coccidioidomycosis. In: Goldman L, Schafer Al, eds. Goldman's Cecil Medicine. 23rd ed. Philadelphia, Pa: Elsevier Saunders; 2011: chap 341.
Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial Team.