Table 2. Recommendations
Suspected
condition Recommendation
Coccidioidomycosis In patients with appropriate geographic exposure and illness
compatible with infection or pneumonia due to coccidioidomycosis,
the ATS suggests using more than one diagnostic test, including
direct visualization and culture of sputum BAL or other biopsy
material, urine and serum antigen testing, and serolog y (serum
antibody testing ). (Conditional recommendation, moderate quality
evidence)
Note: The current evidence cannot support a single best test.
The approach should be tailored based on the severity of illness,
the clinical context and availability of tests.
In patients with suspected coccidioidomycosis, particularly in
immunocompromised patients, the ATS suggests performing
urinary and serum antigen testing to aid in establishing the
diagnosis. (Conditional recommendation, moderate quality
evidence)
In patients with suspected community acquired pneumonia (CAP)
from the endemic area for coccidioidomycosis, the ATS suggests
initial serological testing with close clinical follow up and serial
testing. (Conditional recommendation, moderate quality evidence)
(cont'd)
