Isolation of fungi (molds and yeast) from clinical specimens.

Blood:

See 6580 - Fungus culture - blood

Hair and nails:

See 888 - Fungus culture - skin, hair and nails

Vaginal, mouth, stool and specimens for yeast only:

See 6548 - Yeast culture

Screw cap plastic container (sterile)

• Sputum: As much as available
• Bronchoscopy/Tracheal Aspirate: 1 mL

First morning specimens produced by a deep cough are optimal

Screw cap plastic container (sterile)

• Tissue
• Ear, Exudate, Eye, Lesion, Nose, Pus, Sinus, Throat, Ulcer, or Wound
• Urine
• Normally sterile body fluid such as pleural, peritoneal, pericardial, spinal fluid, or synovial fluid

Tissue:

Screw cap plastic container (sterile)

(Alternative Eswab listed below)

Ear, Exudate, Eye, Lesion, Nose, Pus, Sinus, Throat, Ulcer, or Wound:

Eswab collection kit:

Urine:

Screw cap plastic container (sterile)

Normally sterile body fluid such as pleural, peritoneal, pericardial, spinal fluid, or synovial fluid:

Screw cap plastic container (sterile)

Tissue:

Place tissue in sterile container cover with enough sterile saline to keep moist. 

Alternatively, place tissue in Eswab container.

Ear, Exudate, Eye, Lesion, Nose, Pus, Sinus, Throat, Ulcer, or Wound:

Submit Eswab

Normally sterile body fluid such as pleural, peritoneal, pericardial, spinal fluid, or synovial fluid:

Submit in sterile container.

Urine:

Collect 10-20 mL of catherized or midstream urine in a sterile container. First early morning specimens are prefereable.

Tissue:

ESwab standard tip collection kit (white)

• Identify source

Bronchoscopy, Body Fluid, Ear, Exudate, Eye, Lesion, Nose, Pus, Sinus, Sputum, Throat, Tissue, Ulcer, or Wound:

Refrigerated - 48 hours

Urine:

Refrigerated - 12 hours

• Improper label (unlabeled or mislabeled)
• Time delay between time of collection and receipt of specimen
• Inappropriate timing of collection
• Improper transport container
• Improper transport temperature
• Inappropriate specimen type
• Expectorated sputum with oropharyngeal contamination
• 24 hour sputum collections 
• 24 hour urine collections
• Leaking container

Culture

Clinical and Interpretative Data

Presence of systemic pathogenic fungi may be demonstrated in respiratory specimens. Significant isolates are: Coccidioides immitis, Blastomyces dermatitidis, Histoplasma capsulatum, Aspergillus fumigatus, and Cryptococcus neoformans.

Molds or yeast reported from culture need to be evaluated in the clinical context of the patient:

• Fungi repeatedly isolated from clinical specimens of the same patient.
• Patients with underlying conditions putting them at higher risk for fungal infection such as immunocompromised, diabetes, or burns.
• Treatment with antibiotics suppressing normal bacterial flora allowing overgrowth of normal fungal flora.

Candida species frequently exist on the mucosal and skin surfaces without disease production.

Cultures positive for Coccidioides immitis, Blastomyces dermatitidis, Histoplasma capsulatum, or Cryptococcus neoformans.