Test Id : CIMRP
Coccidioides immitis/posadasii, Molecular Detection, PCR, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Rapid detection of Coccidioides DNA, preferred method
An aid in diagnosing coccidioidomycosis
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Meningitis/Encephalitis Panel Algorithm.
Method Name
A short description of the method used to perform the test
Real-Time Polymerase Chain Reaction (PCR)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Cocci
Cocci PCR
San Joaquin Valley Fever
Valley Fever
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Meningitis/Encephalitis Panel Algorithm.
Specimen Type
Describes the specimen type validated for testing
Varies
Shipping Instructions
Specimen must arrive within 7 days of collection; specimen >7 days will be rejected.
Necessary Information
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| SRC64 | Coccidioides PCR, Specimen Source |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
The high sensitivity of amplification by polymerase chain reaction (PCR) requires the specimen to be processed in an environment in which contamination of the specimen by Coccidioides species DNA is unlikely.
Preferred Specimens: Body fluid, cerebrospinal fluid (CSF), ocular fluid, respiratory (eg, bronchoalveolar lavage [BAL], bronchial washing, sputum), fresh tissue, or bone
Acceptable Specimens: If no fresh specimen is available, digested respiratory specimens treated with N-acetyl-L-cysteine-sodium hydroxide (NALC/NaOH) are acceptable (eg, BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion)
Submit only 1 of the following specimens:
Specimen Type: Body fluid
Sources: Body, ocular, or CSF
Container/Tube: Sterile container
Specimen Volume: 1 mL
Additional Information: Only fresh, non-NALC/NaOH-digested body fluid is acceptable.
Specimen Type: Respiratory
Sources: BAL, bronchial washing, or sputum
Container/Tube: Sterile container
Specimen Volume: 1 mL if only PCR ordered or 3 mL if PCR ordered with smear and culture
Specimen Type: Tissue
Sources: Fresh tissue or bone
Container/Tube: Sterile container
Specimen Volume: 5 to 10 mm
Collection Instructions: Keep moist with sterile water or sterile saline
Additional Information: Only fresh, non-NALC/NaOH-digested tissue is acceptable.
Acceptable
Specimen Type: NALC/NaOH-digested respiratory specimens
Sources: BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion
Container/Tube: Sterile container
Specimen Volume: 2 mL
Collection Instructions:
1. Submit digested specimen treated with NALC/NaOH.
2. Clearly indicate on container and order form that specimen is a digested specimen.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
Body fluid or nondigested respiratory specimen: 0.5 mL; Fresh tissue or bone: 5 mm; NALC-NaOH-digested specimen: 1 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Blood Bone marrow Specimen in anaerobe vial or viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth) Feces Swabs Tissues in formalin fluid Urine | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated (preferred) | 7 days | |
| Frozen | 7 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Rapid detection of Coccidioides DNA, preferred method
An aid in diagnosing coccidioidomycosis
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Meningitis/Encephalitis Panel Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Coccidioidomycosis is caused by the dimorphic fungi, Coccidioides immitis and Coccidioides posadasii. These organisms are endemic to the southwestern regions of the United States, northern Mexico, and areas of Central and South America, with recent literature suggests the geographic area of endemicity may be expanding over time.
The gold standard for the diagnosis of coccidioidomycosis is culture of the organism from clinical specimens due to its high sensitivity. However, growth in culture may take up to several weeks, which can delay diagnosis and treatment. In addition, the propagation of Coccidioides species in the clinical laboratory is a significant safety hazard to laboratory personnel.
This polymerase chain reaction method can identify Coccidioides species directly from clinical specimens, allowing for a rapid diagnosis. Fungal culture should also always be performed since it may enhance detection, and the isolate may be needed for antifungal susceptibility testing.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Not applicable
Interpretation
Provides information to assist in interpretation of the test results
A positive result indicates presence of Coccidioides DNA.
A negative result indicates absence of detectable Coccidioides DNA.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test should always be performed in conjunction with fungal culture.
This rapid polymerase chain reaction assay detects Coccidioides nucleic acid and, therefore, does not distinguish between viable, disease-related organisms and transient colonizing organisms or nucleic acid persisting from old disease. Test results should be correlated with patient symptoms and clinical presentation before a definitive diagnosis is made.
A negative result does not rule out the presence of Coccidioides or active disease because the organism may be present at levels below the limit of detection for this assay.
This test does not distinguish between Coccidioides immitis and Coccidioides posadasii.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Williams SL, Chiller T: Update on the epidemiology, diagnosis, and treatment of coccidioidomycosis. J Fungi (Basel). 2022 Jun 25;8(7):666. doi: 10.3390/jof8070666
2. Thompson GR, Ampel NM, Blair JE, et al: Controversies in the management of central nervous system coccidioidomycosis. Clin Infect Dis. 2022 Sep 10;75(4):555-559. doi: 10.1093/cid/ciac478
3. Boro R, Iyer PC, Walczak MA: Current landscape of coccidioidomycosis. J Fungi (Basel). 2022 Apr 17;8(4):413. doi: 10.3390/jof8040413
Method Description
Describes how the test is performed and provides a method-specific reference
Following specimen processing, nucleic acids are extracted, and the extract transferred to individual self-contained cuvettes for amplification using the LightCycler real-time polymerase chain reaction (PCR) platform (Roche Applied Sciences). The LightCycler is an automated instrument that amplifies and monitors the development of target nucleic acid (amplicon) after each cycle of PCR. The detection of amplicon is based on fluorescence resonance energy transfer, which utilizes hybridization probes. The presence of the specific organism nucleic acid is confirmed by performing a melting curve analysis of the amplicon.(Binnicker MJ, Buckwalter SP, Eisberner JJ, et al: Detection of Coccidioides species in clinical specimens by real-time PCR. J Clin Microbiol. 2007 Jan;45(1):173-178)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Sunday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
87798
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| CIMRP | Coccidioides PCR | 97916-1 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| SRC64 | Coccidioides PCR, Specimen Source | 31208-2 |
| 88804 | Coccidioides PCR, Result | 97916-1 |