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Positive reaction to allergen
Positive reaction to allergen

Coccidioidin or spherulin skin test
Definition:

Coccidioides is a fungus that causes coccidioidomycosis. Coccidioidomycosis is common in the San Joaquin Valley of California and certain other areas in the Southwestern U.S. Symptoms resemble pneumonia or pulmonary tuberculosis. There may be small, red, inflamed areas on the skin. This test detects exposure to this fungus.

Coccidioidin and spherulin are two different antigens and are both used. Spherulin may be a more sensitive test than coccidioidin.



How the test is performed:
The test site (an area with hair, usually the forearm) is cleansed. The allergen is then injected just below the skin surface. The test is read at 24 hours and at 48 hours.
How to prepare for the test:
Adults:
No special preparation is necessary.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
There will be a brief sting as a needle is inserted just below the skin's surface.
Why the test is performed:
The test detects if the body's immune system responds to the fungus, indicating that the person has been exposed to this organism.
Normal Values:
No reaction (inflammation) to the microorganism is normal.
What abnormal results mean:

A positive reaction indicates there has been exposure to the microorganism. This test can be very helpful in diagnosing early infection, since the skin test can be positive 2-21 days after the onset of symptoms, even before serology is positive. A significant number of patients will have anergy, or will not respond to this test even when they have the disease.

There can be false-positives, in that there can be positive results when the patient has been exposed to the funguses Histoplasma or Blastomyces, but not Coccidioides.

What the risks are:
There is a slight risk of anaphylactic shock (a severe reaction).
Special considerations:
Not applicable.
Review Date: 1/13/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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