Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

Voriconazole is a new second-generation triazole antifungal agent. It has been shown to have 10-500 times more potent activity against a broad spectrum of clinically significant fungal pathogens in immunocompromised patients, including fluconazole-resistant Candida and Aspergillus species, as well as emerging fungal pathogens, such as Scedosporium and Fusarium species, which may be resistant to itraconazole, fluconazole, and amphotericin B. Voriconzaole is predominantly metabolized in the liver by the cytochrome P450 enzyme system, mainly by the isozyme CYP2C19. Because of a genetic disposition towards a greater metabolism of the drug by certain population groups, a less effective metabolism by those with hepatic impairment, and because co-administration of other drugs may function to increase or decrease the systemic concentration of voriconazole, it may be clinically helpful to assay the serum/plasma level of voriconazole.
Pharmacokinetic data to this point indicate that achievable steady state levels range from 2 to 6 mcg/mL depending upon the dosing used. The usual standard dosage is 200 mg BID PO or 4 mg/kg IV, but this can vary.

This test is approved for New York patient testing.

WA1 is a Babesia-like piroplasm associated with cases of babesiosis in the Pacific Northwest. Little, if any, crossreactivity occurs between Babesia microti and WA1.

This test is not approved for New York patient testing.

Patients infected with Rickettsial species produce antibodies that agglutinate proteus antigens.

This test is approved for New York patient testing.

Diagnosis of West Nile Virus is currently based on serology, virus isolation and identification, or molecular techniques. RT-PCR testing may be performed as an adjunct to serologic testing, which is considered the most sensitive laboratory tool to diagnoseWest Nile Virus. The detection of West Nile Virus RNA is based upon reverse transcription of specific West Nile Virus genomic RNA sequences followed by PCR amplification.

This test is not approved for New York patient testing.

West Nile Virus IgM is usually detectable by the time symptoms appear, but IgG may not be detectable until day 4 or day 5 of illness. Antibodies induced by other flavivirus infections (eg, Dengue Fever Virus, St. Louis Encephalitis Virus) show extensive crossreactivity with West Nile Virus.

This test is approved for New York patient testing.

The plaque reduction neutralization test (PRNT) is used to confirm the presence in a specimen of neutralizing antibodies specific for West Nile Virus (WNV) versus St. Louis Encephalitis virus (SLE). The test is considered 'positive' for WNV at a titer 1:5 or greater, with a 4-fold higher titer than SLE. The PRNT test satisfies the CDC requirement for performing a WNV-specific serology test. Positive results will be reported to the Health Department.

In acute West Nile Virus infection, specific antibodies are sometimes detectable in CSF before they are detectable in serum.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is not approved for New York patient testing.

West Nile Virus (WNV) IgM is usually detectable by the time symptoms appear. Although WNV IgM persists for more than a year in some patients with WNV encephalitis, detection of WNV IgM remains a reliable indicator of recent infection for most patients. Antibodies induced by other flavivirus infections (eg, Dengue Fever Virus, St. Louis Encephalitis Virus) show extensive crossreactivity with West Nile Virus; thus, antibody detection using this panel is not diagnostically conclusive for WNV infection. Final diagnosis should be based on confirmatory assays, such as the plaque reduction neutralization test.

This test is approved for New York patient testing.

In the very early stages of acute West Nile Virus (WNV) infection, IgM may be detectable in CSF before it becomes detectable in serum. Antibodies induced by other flavivirus infections (eg, Dengue Fever Virus, St. Louis Encephalitis Virus) show extensive crossreactivity with West Nile Virus); thus, antibody detection using this panel is not diagnostically conclusive for WNV infection. Final diagnosis should be based on confirmatory assays, such as the plaque reduction neutralization test. WNV antibody results for CSF should be interpreted with caution. Complicating factors include low antibody levels found in CSF, passive transfer of antibody from blood, and contamination via bloody taps.

This test is not approved for New York patient testing.

This unit code has been inactivated.

Please see unit code 40428.

Detection of IgG antibody indicates either past or recent infection. Human infections are seasonal, from mid-summer to late summer, occurring throughout the western U.S. Minimal crossreactivity with other Group A arboviruses (i.e., Eastern Equine Encephalitis Virus) is observed.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is available for New York patient testing.

This highly sensitive test usually detects IgG and/or IgM antibody in acute specimens. Human infections are seasonal, from mid-summer to late summer, occurring throughout the western United States. Minimal crossreactivity with other Group A arboviruses (i.e., Eastern Equine Encephalitis virus) is observed.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is available for New York patient testing.

Detection of IgM antibody indicates recent or current infection. Human infections are seasonal, from mid-summer to late summer, occurring throughout the western U.S. Minimal crossreactivity with other Group A arboviruses (i.e., Eastern Equine Encephalitis Virus) is observed.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is available for New York patient testing.

• Tropheryma whipplei DNA, Qualitative Real-Time PCR

• Bordetella pertussis IgG and IgA Antibodies, MAID
• Bordetella pertussis IgG Antibodies, MAID
• Bordetella pertussis/parapertussis DNA, Qualitative Real-Time PCR

This unit code has been inactivated.

Please see unit code 40450.