Table 4: Parameters of accuracy of serological tests for diagnosis of paracoccidioidomycosis. Detection of serum antibodies. Cross reactions with other diseases.

Accuracy Parameters
Method Antigen S E* PPV NPV A PLR NLR Ref.
CFa FL 93.0 96.7 93.0 96.7 95.5 31.0 0.06 336
CFa FL 69.5 100.0 100.0 100.0 84.9 34.5 0.30 337
RFC Po … … … … … … … 339
DID FL 76.2 100.0 100.0 90.0 93.0 38.0 0.23 23
CIE FL 77.0 95.0 … … 94.0 … … 341
LA Crude
Ethanol		 69.6
60.9		 80.0
83.0		 61.5
62.2		 85.1
82.2		 76.7
76.0		 3.45
3.52		 0.37
0.47		 342
LA Crude 84.0 100.0 100.0 71.0 88.0 21.0 0.15 343
IFA FL 98.0 82.0 97.0 95.0 94.0 12.25 0.01 346
ELISAb FL 100.0 100.0 100.0 100.0 100.0 125.0 0.014 348
ELISAc CT 66.0 95.0 94.0 68.0 78.0 13.2 0.35 349
ELISA gp43 100.0 … … … … … … 350
Dot-blot p 27 recombinant 100.0 100.0 100.0 100.0 100.0 11.1 0.09 352
Dot-blot gp43 100.0 … … … … … … 353
Dot-ELISA FL 91.0 95.4 96.0 98.2 93.0 … … 354
IB gp43
gp70		 100.0
96.0		 ...
...		 ...
...		 ...
...		 ...
...		 ...
...		 ...
...		 355
IDD CFA-Pl
exo-Pl
TCA-Pl		 100
58.8
17.6		 100.0
100.0
100.0		 100.0
100.0
100.0		 100.0
89.5
22.0		 ...
...
...		 ...
...
...		 ...
...
...		 356
ELISAd FL 96.0
96.9		 95.0
95.1		 95.0
95.0		 96.0
97.0		 95.5
96.0		 19.2
31.67		 0.04
0.05		 368
Cross reactions**
Method Antigen TBC HST ASP CRC LSZ CCD ESP Ref.
CFa FL 3.3 23.5 3.8 … … … … 336
CFa FL 0.0 14.2 0.0 0.0 0.0 … … 337
RFC Po … 52.6 … 60.0 … 0.0 65.2 339
DID FL … 0.0 … … … 0.0 0.0 23
CIE FL … … … … … … … 341
LA Crude
Ethanol		 17.0
32.0		 46.9
34.4		 47.4
15.8		 …
…		 …
…		 …
…		 …
…		 342
LA Crude … 27.2 26.7 … … … … 343
IFA FL 8.0 34.0 … … … 2.0 … 346
ELISAb FL 33.0 55.0 22.0 50.0 55.0 … 0.0 348
ELISAc CT … 36.0 … 0.0 … 0.0 … 349
ELISA gp43 … 53.1 … … 30.7 … … 350
Dot-blot p 27 recombinant 0.0 0.0 10.0 0.0 … 0.0 0.0 352
Dot-blot gp43 … 0.0 0.0 0.0 31.3 … … 353
Dot-ELISA FL … … … … … … … 354
IB gp43
gp70		 …
…		 100.0
42.5		 0.0
0.0		 …
…		 0.0
0.0		 …
…		 …
…		 355
IDD CFA-Pl
exo-Pl
TCA-Pl		 …
…
…		 …
…
…		 …
…
…		 …
…
…		 …
…
…		 …
…
…		 …
…
…		 356
ELISAd FL 41.4
20.7		 35.8
34.8		 43.5
28.5		 …
…		 …
…		 …
…		 …
…		 368

*Evaluated in healthy donors; ** Evaluated in patients with microbiologically confirmed active disease; DID: double agar gel immunodiffusion test; ELISA: enzyme-linked immunosorbent assay; CF: complement fixation; CIE: counterimmunoelectrophoresis; IFA: indirect immunofluorescence assay; LA: latex agglutination test; IB: immunoblotting assay; cut-off - a: ≥1:8;b: 1:80; c: 2,0; d: 0.710 and 0.850; FL: culture filtrate antigen yeast phase; CT: cytoplasmic antigen; Po: polysaccharide antigen; p 27: recombinant proteinEthanol: antigen treated with ethanol; Exo-Pl: crude exoantigen of P. lutzii; CFA-Pl: cell free antigen of P. lutzii; TCA-Pl: crude exoantigen of P. lutzii precipitated with trichloroacetic acid) S: sensitivity, E: specificity; PPV / NPV: positive and negative predictive values; A: accuracyPLR: positive likelihood ratio; NLR: negative likelihood ratio; TBC: tuberculosis; HST: histoplasmosis; ASP: aspegillosis; CRC: cryptococcosis; LSZ: lacaziosis; CCD: coccidioidomycosis; ESP: esporotrichosis.