VALUE OF SKIN-TEST AND COMPLEMENT-FIXATION TEST IN DIAGNOSIS OF CHRONIC PULMONARY HISTOPLASMOSIS

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Abstract
Histoplasmin skin test results in patients with chronic pulmonary [Histoplasma capsulatum] histoplasmosis from Missouri and Texas [USA] were compared to results in a previous study of United States Navy recruits. Consideration of the geographic areas from which persons from each group were admitted to the study suggested that the recruits were as likely to have a positive skin test as those with the disease. The Texas histoplasmosis patients were compared to groups of patients from that state with chronic obstructive pulmonary disease and with pulmonary tuberculosis. Again, no significant differences were found. The histoplasmin skin test is apparently not of value in the diagnosis of chronic pulmonary histoplasmosis. Histoplasmosis complement fixation test data from the chronic pulmonary histoplasmosis group were compared to data from the chronic obstructive disease and pulmonary tuberculosis groups. The usefulness of the complement fixation test in chronic pulmonary histoplasmosis is limited, by false-positive and false-negative reactions. A decision theory method was used to define the limits of usefulness.