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Topic:Serology

Serology in horse research involves the study and analysis of blood serum to detect the presence of antibodies or antigens associated with infectious diseases and other health conditions. It is a diagnostic tool used to identify immune responses to pathogens, vaccination status, and exposure to specific diseases. Serological tests in equine research can include enzyme-linked immunosorbent assays (ELISA), complement fixation tests, and virus neutralization tests. These tests help in understanding the epidemiology of diseases, monitoring herd health, and informing vaccination strategies. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and implications of serological testing in equine medicine.
Detection of antibodies to equine arteritis virus in horse sera using recombinant chimaeric N/G(L) protein.
The Veterinary record    September 11, 2007   Volume 161, Issue 10 352-354 doi: 10.1136/vr.161.10.352
Turan N, Ekici H, Yilmaz H, Kondo T, Hasoksuz M, Sato I, Tuchiya K, Fukunaga Y.No abstract available
Detection and molecular characterization of Babesia caballi and Theileria equi isolates from endemic areas of Brazil.
Parasitology research    September 9, 2007   Volume 102, Issue 1 63-68 doi: 10.1007/s00436-007-0726-1
Heim A, Passos LM, Ribeiro MF, Costa-Júnior LM, Bastos CV, Cabral DD, Hirzmann J, Pfister K.Blood samples were collected from 487 adult horses, including 83 pregnant mares, at a slaughterhouse located in Araguari, Minas Gerais State, Brazil. For each blood sample, the packed cell volume (PCV) was determined, and Giemsa-stained smears were microscopically examined for the presence of hemoparasites. The plasma was examined by the indirect fluorescent antibody test for detection of antibodies against Babesia caballi and Theileria equi. In addition, DNA was extracted and analyzed by a multiplex real-time polymerase chain reaction (PCR), specific for B. caballi and T. equi. Products of PC...
Prevalence of equine herpesvirus-1 infection among Thoroughbreds residing on a farm on which the virus was endemic.
Journal of the American Veterinary Medical Association    August 19, 2007   Volume 231, Issue 4 577-580 doi: 10.2460/javma.231.4.577
Brown JA, Mapes S, Ball BA, Hodder AD, Liu IK, Pusterla N.To determine the incidence of equine herpesvirus-1 (EHV-1) infection among Thoroughbreds residing on a farm on which the virus was known to be endemic. Methods: Prospective cohort study. Methods: 10 nonpregnant mares, 8 stallions, 16 weanlings, 11 racehorses, and 30 pregnant mares and their foals born during the 2006 foaling season. Methods: Blood and nasopharygeal swab samples were collected every 3 to 5 weeks for 9 months, and placenta and colostrum samples were collected at foaling. All samples were submitted for testing for EHV-1 DNA with a PCR assay. A type-specific EHV-1 ELISA was used t...
An investigation of equine infectious anaemia infection in the central Anatolia region of Turkey.
Journal of the South African Veterinary Association    August 2, 2007   Volume 78, Issue 1 12-14 doi: 10.4102/jsava.v78i1.279
Yapklç O, Yavru S, Kale M, Bulut O, Simşek A, Sahna KC.In this study, 162 horses, 80 donkeys and 51 mule serum samples were collected in Konya city. Additionally, 64 horse serum samples from Ankara and 49 samples from Kayseri city were included in the study. A total of 406 serum samples were examined by agar gel immunodiffusion (AGID) and enzyme-linked immunosorbent assay (ELISA) for antibody to equine infectious anaemia virus (EIAV) and no positive result was detected.
Validation of the indirect fluorescent antibody and the complement fixation tests for the diagnosis of Theileria equi.
Veterinary parasitology    July 13, 2007   Volume 148, Issue 2 102-108 doi: 10.1016/j.vetpar.2007.06.006
Ogunremi O, Georgiadis MP, Halbert G, Benjamin J, Pfister K, Lopez-Rebollar L.The indirect fluorescent antibody (IFA) test for Theileria equi was evaluated to assess test's suitability for the serological diagnosis of equine piroplasmosis, to provide performance parameters for the purpose of test validation, and to compare it with the complement fixation (CF) test. Using a protocol that included Evan's blue, the specificity of the IFA test was estimated at 99.0% for T. equi by the classical method of analysis, and 96.6% by the Bayesian method. The use of Evan's blue in the test protocol increased test specificity and contributed to an excellent test agreement between tw...
[Presence of west Nile virus in northeast Mexico].
Salud publica de Mexico    June 26, 2007   Volume 49, Issue 3 210-217 doi: 10.1590/s0036-36342007000300006
Fernández-Salas I, de Lourdes Garza-Rodríguez M, Beaty BJ, Jiménez JR, Rivas-Estilla AM.To investigate the presence of WNV in birds, horses and humans in northeast Mexico. Methods: Serum samples from 33 birds, 24 horses and 237 humans were screened by ELISA for Anti-WNV antibodies. Human serum samples were also screened for WNV RNA using an RT-PCR assay. Results: Positive sera were found in three birds and 15 horses. Forty percent of the human serum samples were positive for IgG antibodies and 0% for IgM antibodies and viral RNA. Conclusions: The results of this study show that WNV is present in northeast Mexico and it is a new emergent infectious agent that represents a challeng...
Lawsonia intracellularis proliferative enteropathy in a foal.
Schweizer Archiv fur Tierheilkunde    April 7, 2007   Volume 149, Issue 3 129-133 doi: 10.1024/0036-7281.149.3.129
Feary DJ, Gebhart CJ, Pusterla N.A weanling foal was diagnosed with proliferative enteropathy caused by Lawsonia intracellularis based on history, clinical findings of depression, anorexia, weight loss, colic, diarrhea, and ventral edema, and a combination of serology and fecal PCR. An epidemiological investigation on the premises revealed that many of the other foals and adult horses were seropositive for L. intracellularis, despite being clinically normal, and identified a dog as a potential carrier and source of infection for the foal. The foal was successfully treated with a combination of azithromycin and rifampin.
Larval viability and serological response in horses with long-term Trichinella spiralis infection.
Veterinary parasitology    March 26, 2007   Volume 146, Issue 1-2 107-116 doi: 10.1016/j.vetpar.2007.02.011
Hill DE, Forbes L, Kramer M, Gajadhar A, Gamble HR.The horse is considered an aberrant host for the nematode parasite Trichinella spiralis, and many aspects of the biology and epidemiology of Trichinella infection in the horse are poorly understood. It has been reported that experimentally-infected horses produce a transient serological response to infection and that muscle larvae are cleared more rapidly than in parasite-adapted hosts such as the pig and humans. However, limited numbers of animals have been studied, and both the longevity of larvae in horse musculature and the immune response to Trichinella larvae remain unclear. In this stud...
Detection of viruses in nasal swab samples from horses with acute, febrile, respiratory disease using virus isolation, polymerase chain reaction and serology.
Australian veterinary journal    February 16, 2007   Volume 85, Issue 1-2 46-50 doi: 10.1111/j.1751-0813.2006.00096.x
Dynon K, Black WD, Ficorilli N, Hartley CA, Studdert MJ.To examine the association of viruses with acute febrile respiratory disease in horses. Design Nasal swab and serum samples were collected from 20 horses with acute febrile upper respiratory disease that was clinically assessed to have a viral origin. Methods: Each of the samples was inoculated onto equine fetal kidney, RK13 and Vero cell cultures, and viral nucleic acid was extracted for polymerase chain reaction (PCR) or reverse transcription PCR. PCR primers were designed to amplify nucleic acid from viruses known to cause or be associated with acute febrile respiratory disease in horses in...
Incidence and effects of West Nile virus infection in vaccinated and unvaccinated horses in California.
Veterinary research    February 6, 2007   Volume 38, Issue 1 109-116 doi: 10.1051/vetres:2006045
Gardner IA, Wong SJ, Ferraro GL, Balasuriya UB, Hullinger PJ, Wilson WD, Shi PY, MacLachlan NJ.A prospective cohort study was used to estimate the incidence of West Nile virus (WNV) infection in a group of unvaccinated horses (n = 37) in California and compare the effects of natural WNV infection in these unvaccinated horses to a group of co-mingled vaccinated horses (n = 155). Horses initially were vaccinated with either inactivated whole virus (n = 87) or canarypox recombinant (n = 68) WNV vaccines during 2003 or 2004, prior to emergence of WNV in the region. Unvaccinated horses were serologically tested for antibodies to WNV by microsphere immunoassay incorporating recombinant WNV E ...
West Nile virus: recent trends in diagnosis and vaccine development.
Vaccine    December 22, 2006   Volume 25, Issue 30 5563-5576 doi: 10.1016/j.vaccine.2006.12.005
Dauphin G, Zientara S.West Nile virus (WNV) is a mosquito-borne flavivirus, native to Africa, Europe, and Western Asia. In many respects, WNV is an outstanding example of a zoonotic pathogen that has leaped geographical barriers and can cause severe disease in human and horse. Before the emergence of WNV in the USA, only few methods of diagnosis were available. Recently, many changes in the fields of WN diagnosis and prevention have happened. This paper will review all these new tools. After a description of the main concerns in WNV and West Nile (WN) disease in humans and animals, this review will present the main...
Comparative serological diagnosis of toxoplasmosis in horses using locally isolated Toxoplasma gondii.
Veterinary parasitology    December 14, 2006   Volume 145, Issue 1-2 31-36 doi: 10.1016/j.vetpar.2006.11.010
Ghazy AA, Shaapan RM, Abdel-Rahman EH.A total of 420 serum samples collected from horses of different ages, sexes and breeds, located at some horse farms in Egypt, were used for serological studies. A crude antigen of the locally isolated Toxoplasma gondii tachyzoites from horse tissues (LA) was used for the detection of T. gondii antibodies in horses. It showed good diagnostic efficiency (38.1%) by Enzyme Linked Immunosorbent Assay (ELISA). To increase this efficiency, an affinity purification process was performed. Two fractions were obtained from LA by CNBr-Sepharose 4B affinity column chromatography named; unbound (LAunb) and ...
New findings on anaplasmosis caused by infection with Anaplasma phagocytophilum.
Annals of the New York Academy of Sciences    December 1, 2006   Volume 1081 360-370 doi: 10.1196/annals.1373.053
Lillini E, Macrì G, Proietti G, Scarpulla M.Ixodes ricinus (I. ricinus) is one of the vectors of Anaplasma phagocytophilum (A. phagocytophilum) in Europe, in which rates of infection range from 1.9% to 34%. In 1998, human granulocytic ehrlichiosis-like (HGE-like) Ehrlichia DNA was detected in Italy, by PCR technique in one I. ricinus nymph out of 55 ticks that were examined. In 1996, 6.3% of 310 human sera in high-risk subjects from Italy were found positive for antibodies to Ehrlichia phagocytophila (E. phagocytophila). In the same year, the authors reported the first case of equine granulocytic ehrlichiosis. In 1997, only 2 out of 563...
Monoclonal antibody-based competitive enzyme-linked immunosorbent assay for detecting and quantifying West Nile virus-neutralizing antibodies in horse sera.
Clinical and vaccine immunology : CVI    November 29, 2006   Volume 14, Issue 2 134-138 doi: 10.1128/CVI.00322-06
Choi KS, Ko YJ, Nah JJ, Kim YJ, Kang SY, Yoon KJ, Joo YS.A rapid immunoassay for detecting and quantifying West Nile virus (WNV)-neutralizing antibodies in sera was developed as an alternative to the plaque reduction neutralization test (PRNT), the gold standard test for WNV. The assay is a competitive, enzyme-linked immunosorbent assay using neutralizing monoclonal antibody 5E8 (NT-ELISA). A cutoff percent inhibition (PI) value of 35% (mean PI plus 3 standard deviations), with a specificity of 99%, was established based on analysis of 246 serum samples from horses free of WNV. The NT-ELISA detected neutralizing antibodies in all sera collected 7 or...
Passive transfer of naturally acquired specific immunity against West Nile Virus to foals in a semi-feral pony herd.
Journal of veterinary internal medicine    September 8, 2006   Volume 20, Issue 4 1045-1047 doi: 10.1892/0891-6640(2006)20[1045:ptonas]2.0.co;2
Wilkins PA, Glaser AL, McDonnell SM.Horses naturally exposed to West Nile Virus (WNV) or vaccinated against WNV develop humoral immunity thought to be protective against development of clinical disease in exposed or infected animals. No reports evaluate the efficacy of passive transfer of naturally acquired specific WNV humoral immunity from dam to foal. The purpose of this study was to investigate passive transfer of naturally acquired immunity to WNV to foals born in a herd of semi-feral ponies, not vaccinated against WNV, in an endemic area, with many dams having seroconverted because of natural exposure. Microwell serum neut...
Formulation with CpG ODN enhances antibody responses to an equine influenza virus vaccine.
Veterinary immunology and immunopathology    September 6, 2006   Volume 114, Issue 1-2 103-110 doi: 10.1016/j.vetimm.2006.07.013
Lopez AM, Hecker R, Mutwiri G, van Drunen Littel-van den Hurk S, Babiuk LA, Townsend HG.Previous studies have shown that protection against equine influenza virus (EIV) is partially mediated by virus-specific IgGa and IgGb. In this study we tested whether addition of a CpG ODN formulation to a commercial killed virus vaccine would enhance EIV-specific IgGa and IgGb antibody responses, and improve protection against an experimental EIV challenge. Thirty naïve horses were assigned to one of three groups and vaccinated as follows: 10 were given vaccine (Encevac TC4, Intervet Inc.) alone, 10 were given vaccine plus 0.25 mg CpG ODN 2007 formulated with 30% Emulsigen (CpG/Em), and 10 ...
Reverse transcription real-time PCR assays for detection and quantification of Borna disease virus in diseased hosts.
Molecular and cellular probes    August 30, 2006   Volume 21, Issue 1 47-55 doi: 10.1016/j.mcp.2006.08.001
Schindler AR, Vögtlin A, Hilbe M, Puorger M, Zlinszky K, Ackermann M, Ehrensperger F.Borna disease is a severe, immunopathological disorder of the central nervous system caused by the infection with the Borna disease virus (BDV). The detection of BDV in diseased animals, mainly sheep and horses, is achieved by histological, immunohistochemical and serological approaches and/or PCR-based technologies. In the present study, reverse transcription, real-time PCR assays were established for the detection of BDV in the brain tissue from sheep and horses, using loci for the p40 (nucleoprotein) and the p24 (phosphoprotein) genes. The PCRs were equally specific and sensitive, detecting...
Characteristics of an outbreak of West Nile virus encephalomyelitis in a previously uninfected population of horses.
Veterinary microbiology    July 26, 2006   Volume 118, Issue 3-4 255-259 doi: 10.1016/j.vetmic.2006.07.016
Ward MP, Schuermann JA, Highfield LD, Murray KO.Equine West Nile virus (WNV) encephalomyelitis cases - based on clinical signs and ELISA serology test results - reported to Texas disease control authorities during 2002 were analyzed to provide insights into the epidemiology of the disease within a previously disease-free population. The epidemic occurred between June 27 and December 17 (peaking in early October) and 1,698 cases were reported. Three distinct epidemic phases were identified, occurring mostly in southeast, northwest and then central Texas. Significant (P<0.05) disease clusters were identified in northwest and northern Texas. M...
Cardiac arrhythmias associated with piroplasmosis in the horse: a case report.
Veterinary journal (London, England : 1997)    June 12, 2006   Volume 174, Issue 1 193-195 doi: 10.1016/j.tvjl.2006.04.003
Diana A, Guglielmini C, Candini D, Pietra M, Cipone M.Cardiac dysfunction is a rare complication of babesiosis in domestic animals. The horse in this report showed clinical signs of anorexia, depression, fever, icterus and brown urine, and laboratory results (monocytosis, thrombocytopenia, azotemia, hyperbilirubinemia and bilirubinuria) indicated sub-acute piroplasmosis. Furthermore, junctional and polymorphic ventricular premature complexes and tachycardia associated with increased serum cardiac troponin I and myocardial-bound creatine kinase concentration were found. The diagnosis of piroplasmosis was confirmed by serology. Specific and support...
Serologic evidence of vesivirus-specific antibodies associated with abortion in horses.
American journal of veterinary research    June 3, 2006   Volume 67, Issue 6 1033-1039 doi: 10.2460/ajvr.67.6.1033
Kurth A, Skilling DE, Smith AW.To test horses for serologic evidence of an association between vesiviral antibodies and abortion. Methods: Sera from 141 horses. Methods: 2 experiments were conducted. Experiment 1 comprised sera obtained in 2001 and 2002 from 3 groups of horses (58 mares from farms with a history of abortion problems, 25 mares between 3 and 13 years of age with unknown reproductive histories that were sold at auction [breeding-age control mares], and 29 mixed-age males and yearling females sold at auction [negative control population]). Experiment 2 comprised sera from 3 groups of pregnant mares (10 pregnant...
West Nile Virus infection in humans and horses, Cuba.
Emerging infectious diseases    May 19, 2006   Volume 12, Issue 6 1022-1024 doi: 10.3201/eid1206.051235
Pupo M, Guzmán MG, Fernández R, Llop A, Dickinson FO, Pérez D, Cruz R, González T, Estévez G, González H, Santos P, Kourí G, Andonova M....A surveillance system to detect West Nile virus (WNV) was established in Cuba in 2002. WNV infection was confirmed by serologic assays in 4 asymptomatic horses and 3 humans with encephalitis in 2003 and 2004. These results are the first reported evidence of WNV activity in Cuba.
West Nile virus activity in Latin America and the Caribbean.
Revista panamericana de salud publica = Pan American journal of public health    March 23, 2006   Volume 19, Issue 2 112-117 doi: 10.1590/s1020-49892006000200006
Komar N, Clark GG.West Nile virus (Flavivirus: Flaviviridae; WNV) has spread rapidly throughout the Caribbean Basin since its initial detection there in 2001. This report summarizes our current knowledge of WNV transmission in tropical America. Methods: We reviewed the published literature and consulted with key public health officials to obtain unpublished data. Results: West Nile virus infections first appeared in human residents of the Cayman Islands and the Florida Keys in 2001, and in apparently healthy Jamaican birds sampled early in 2002. Serologic evidence of WNV infection in 2002 was detected in horses...
Survey on the subject of equine Lyme borreliosis.
International journal of medical microbiology : IJMM    March 9, 2006   Volume 296 Suppl 40 274-279 doi: 10.1016/j.ijmm.2006.01.004
Gall Y, Pfister K.According to the results of a questionnaire on equine Lyme borreliosis addressing veterinarians in Germany, the existence of the disease was confirmed by more than half of the 118 participants. Practitioners who regarded Borrelia burgdorferi as a pathogen of horses seemed to be more sensitized in terms of the number of annually diagnosed cases as well as the frequency of occurrence of tick infestation with equine patients or prophylactic treatments against ectoparasites by horse owners. Chronically poor performance and diverse orthopaedic problems were the clinical symptoms most often leading ...
Heterogeneity of Borrelia burgdorferi sensu lato and their reflection on immune response.
Annals of agricultural and environmental medicine : AAEM    February 25, 2006   Volume 12, Issue 2 211-216 
Stefancíková A, Derdáková M, Stepánová G, Pet'ko B, Szestáková E, Skardová I, Cisláková L.Geographically different strains of Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto Ir 105, B. burgdorferi s.s. + B. afzelii V 123, B. garinii Ir 112 - isolates from eastern Slovakia, B. garinii K24 - isolate from western Slovakia and B. burgdorferi s.s. B 31 - American strain) were compared as antigens for serological study of Lyme borreliosis by IgG ELISA on a group of horses from eastern Slovakia. In a set of 101 horse serum samples, positivity with the use of Ir 105 strain was 53 (52.4%), with V 123 51 (51.49%), with Ir 112 48 (47.5%), with K 24 47 (46.5%) and with B 31 only ...
Development of an indirect enzyme-linked immunosorbent assay for detecting equine serum antibodies to the lipopolysaccharide of Salmonella abortusequi.
Research in veterinary science    February 17, 2006   Volume 81, Issue 2 215-217 doi: 10.1016/j.rvsc.2005.11.004
Gall D, Nielsen K, Bermudez RM, Muñoz del Real MC, Halbert G, Groulx R, Moreno F, Chow EY, Checkley SL.An indirect enzyme-linked immunosorbent assay (IELISA) was developed for the detection of equine serum antibodies to lipopolysaccharide of Salmonella enterica subsp. enterica serovar Abortusequi (LPS), a causative organism of Equine Paratyphoid. The data presented demonstrates that horses immunized with S. abortusequi LPS developed antibodies detectable by the IELISA. By comparison, the tube agglutination test (TAT) did not detect antibody to S. abortusequi LPS as consistently as the IELISA. The data suggests that the IELISA may be a more suitable test for the detection of serum antibodies to ...
Cloning and expression of 51-kDa antigenic protein of Neorickettsia risticii NR-JA1.
Annals of the New York Academy of Sciences    February 17, 2006   Volume 1063 246-251 doi: 10.1196/annals.1355.038
Park MK, Kim EH, Cho MR, Yi YH, Lee MJ, Shah DH, Park JH, Park BK, Eo SK, Lee JH, Chae JS.Neorickettsia (Ehrlichia) risticii is a causative agent of acute diarrheal syndrome in horses, commonly known as Potomac horse fever. Korean isolate of N. risticii NR-JA1 was cultivated in mouse macrophage cell line P388D1. A complete ORF of p51 antigenic protein gene was amplified and cloned into pQE32 and pcDNA3.1 vectors and the resultant clones were named as pQE32/Nr-51 and pcDNA3.1/Nr-51, respectively. Recombinant p51 (rp51) protein antigen was expressed in E. coli (pQE32/Nr-51) and cos-7 cell line (pcDNA3.1/Nr-51). The rp51 protein showed immunoreactivity with anti- mouse p51 antibodies....
Sensitization to horse allergens without apparent exposure to horse. Report of two cases.
European annals of allergy and clinical immunology    February 4, 2006   Volume 37, Issue 9 350-352 
Liccardi G, Dente B, Senna G, De Martino M, D'Amato L, D'Amato G.It has been well established that occupational exposure to horses increases the risk of allergic sensitization to horse hair, on the contrary very few data have been published in individuals without direct contact with horses. We describe two cases of severe respiratory symptoms triggered by a single direct exposure in two patients with only 4-5 previous short contacts with horses during the entire their life, since they live in urban area of Naples. Cutaneous and serological diagnostic tests showed significant sensitization to horse dander other than some common inhalant allergens. Our report...
Equine herpesvirus 2 (EHV-2) infection in thoroughbred horses in Argentina.
BMC veterinary research    November 9, 2005   Volume 1 9 doi: 10.1186/1746-6148-1-9
Craig MI, Barrandeguy ME, Fernández FM.Equine herpesvirus 2 is a gamma-herpesvirus that infects horses worldwide. Although EHV-2 has been implicated in immunosuppression in foals, upper respiratory tract disease, conjunctivitis, general malaise and poor performance, its precise role as a pathogen remains uncertain. The purpose of the present study was to analyse the incidence of EHV-2 in an Argentinean horse population and correlate it with age and clinical status of the animals. Results: A serological study on 153 thoroughbred racing horses confirmed the presence of EHV-2 in the Argentinean equine population. A virus neutralizatio...
Pharmacokinetics of azathioprine following single-dose intravenous and oral administration and effects of azathioprine following chronic oral administration in horses.
American journal of veterinary research    November 3, 2005   Volume 66, Issue 9 1578-1583 doi: 10.2460/ajvr.2005.66.1578
White SD, Maxwell LK, Szabo NJ, Hawkins JL, Kollias-Baker C.To determine pharmacokinetics of azathioprine (AZA) and clinical, hematologic, and serologic effects of i.v. and oral administration of AZA in horses. Methods: 6 horses. Methods: In study phase 1, a single dose of AZA was administered i.v. (1.5 mg/kg) or orally (3.0 mg/kg) to 6 horses, with at least 1 week between treatments. Blood samples were collected for AZA and 6-mercaptopurine (6-MP) analysis 1 hour before and at predetermined time points up to 4 hours after AZA administration. In study phase 2, AZA was administered orally (3 mg/kg) every 24 hours for 30 days and then every 48 hours for ...
Comparison of Coccidioides immitis serological antibody titres between forms of clinical coccidioidomycosis in horses.
Veterinary journal (London, England : 1997)    October 24, 2005   Volume 173, Issue 1 118-123 doi: 10.1016/j.tvjl.2005.09.001
Higgins JC, Pusterla N, Pappagianis D.A retrospective study was performed to determine if there is an association between serological Coccidioides immitis antibody titres (IgG) and form/severity of coccidioidal disease in horses, and to identify trends in survival and treatment success based on the form of the disease. Data were obtained on horses with positive serological titres tested at the Coccidioidomycosis Serology Laboratory, School of Medicine, University of California, Davis from 1981 to 2004. Thirty-nine cases in which a diagnosis of coccidioidomycosis had been made were selected for inclusion. Six distinct categories we...
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