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Case 3: Appropriate Serologic Testing

You answered:

C anti-Histoplasma IgG

This answer is incorrect. Routine testing for exposure to histoplasmosis with either histoplasmin skin test or Histoplasma serology is not predictive of disease and is not recommended. Patients who live in or are visiting areas endemic for histoplasmosis can be counseled in ways to reduce risk of exposure. According to USPPHS/IDSA guidelines, patients with a CD4 count less than 100 cells/mm3 who live in a hyperendemic area (more than 10 cases/100 patient-years) can be considered for primary prophylaxis with itraconazole.

A anti-Toxoplasma IgG
B Hepatitis A, B, and C serologies
D Venereal Disease Research Lab (VDRL) or Rapid Plasma Reagin (RPR)
E A, B, and D

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