The objective of this study was to evaluate the sensitivity and specificity of an antigen enzyme immunoassay (EIA) on urine samples for the diagnosis of histoplasmosis in dogs. This retrospective medical records review included canine cases with urine samples submitted for Histoplasma EIA antigen assay between 2007 and 2011 from three veterinary institutions. Cases for which urine samples were submitted for Histoplasma antigen testing were reviewed and compared to the gold standard of finding Histoplasma organisms or an alternative diagnosis on cytology or histopathology. Sensitivity, specificity, negative predictive value, positive predictive value, and the kappa coefficient and associated confidence interval were calculated for the EIA-based Histoplasma antigen assay. Sixty cases met the inclusion criteria. Seventeen cases were considered true positives based on identification of the organism, and 41 cases were considered true negatives with an alternative definitive diagnosis. Two cases were considered false negatives, and there were no false positives. Sensitivity was 89.47% and the negative predictive value was 95.35%. Specificity and the positive predictive value were both 100%. The kappa coefficient was 0.9207 (95% confidence interval, 0.8131–1). The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.
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September/October 2015
Retrospective Studies|
September 01 2015
Sensitivity and Specificity of Histoplasma Antigen Detection by Enzyme Immunoassay
Lauren Cunningham, DVM, DACVIM;
Lauren Cunningham, DVM, DACVIM
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
*Lauren Cunningham's present affiliation is North Houston Veterinary Specialists, Spring, TX.
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Audrey Cook, BVM&S, DACVIM, DECVIM;
Audrey Cook, BVM&S, DACVIM, DECVIM
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
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Andrew Hanzlicek, MS, DVM, DACVIM;
Andrew Hanzlicek, MS, DVM, DACVIM
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
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Kenneth Harkin, DVM;
Kenneth Harkin, DVM
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
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Joseph Wheat, MD;
Joseph Wheat, MD
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
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Carla Goad, PhD;
Carla Goad, PhD
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
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Emily Kirsch, BS
Emily Kirsch, BS
From the Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences (L.C., A.H.) and Department of Statistics (C.G.), Oklahoma State University, Stillwater, OK; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (A.C.); Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS (K.H.); and MiraVista Diagnostics, Indianapolis, IN (J.W., E.K.).
†Emily Kirsh's present affiliation is Orchard Software Corporation, Carmel, IN.
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J Am Anim Hosp Assoc (2015) 51 (5): 306–310.
Citation
Lauren Cunningham, Audrey Cook, Andrew Hanzlicek, Kenneth Harkin, Joseph Wheat, Carla Goad, Emily Kirsch; Sensitivity and Specificity of Histoplasma Antigen Detection by Enzyme Immunoassay. J Am Anim Hosp Assoc 1 September 2015; 51 (5): 306–310. doi: https://doi.org/10.5326/JAAHA-MS-6202
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