ABSTRACT
Coccidioidomycosis is a deep-seated infection caused by two dimorphic fungal species: Coccidioides immitis and C. posadasii. Histopathological examination for Coccidioides spp. detection is an important diagnostic tool, especially when cultures cannot be performed. The histopathological diagnosis offers results faster than in vitro cultures and costs less than molecular and immunological techniques. Clinical laboratories in endemic areas should provide at least immunological tests for presumptive diagnosis of coccidioidomycosis. Primary cutaneous coccidioidomycosis occurs after traumatic inoculation of fungal structures and is associated with laboratory accidents. The most commonly investigated clinical specimens for laboratory diagnosis of coccidioidomycosis are those from the respiratory tree, such as sputum, and samples obtained by bronchoscopy: bronchoalveolar lavage and endobronchial and transbronchial biopsies. The manipulation of clinical specimens from patients suspected of coccidioidomycosis requires laboratory infrastructure compatible with biosafety level-2. The most relevant diagnostic methods for the detection of humoral response in coccidioidomycosis are gel immunodiffusion and enzyme immunoassay.
