Test Details
Methodology
Culture
Result Turnaround Time
30 - 42 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Test Includes
Culture for fungi. Isolation and identification (additional charges/CPT code[s] may apply) if culture results warrant. CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed.
Use
Isolate and identify fungi. Blood: establish the diagnosis of fungal infections including fungemia, fungal endocarditis, and disseminated mycosis in patients at risk for fungal infections.
Limitations
Blood: A single (or even multiple) negative fungal blood culture does not exclude disseminated fungal infection. If disseminated or deep fungal infection is strongly suspected despite repeatedly negative blood cultures, biopsy of the appropriate tissue and/or bone marrow aspiration for sections and fungus culture should be considered.
Specimen Requirements
Specimen
Biopsy, blood, body fluid, aspirates, bronchoalveolar lavage (BAL), swab of conjunctiva, skin, nails, hair, sputum, throat, tissue, urine or vaginal
Volume
For optimal recovery: 2 mL or 1 cm3 tissue, 10 mL blood, whole nails, 5-10 mL body fluids and BAL, 3-5 mL CSF, 5 mL aspirates or sputum
Minimum Volume
1 mL body fluid including BAL and CSF; aspirates or sputum
Container
Fluid or tissue: sterile screw-capped container
Blood: green-top (sodium heparin) tube, aerobic blood culture bottle
Other: bacterial swab transport including ESwab®
Collection Instructions
Biopsy: Surgical specimen in sterile container. A small amount of sterile nonbacteriostatic water should be added to prevent drying.
Body fluid, aspirates: Aspirated material in sterile container.
Eye: For keratitis, scrapings with a Kimura spatula directly inoculated using “C” streaks are best.
Skin: Cleanse the area with 70% alcohol and collect a portion from the active border of the lesion.
Nails: For all types of onychomycosis, clean the nail area well with 70% alcohol, then, depending on type of nail disease, collect the following:
• Distal subungual: Clip the abnormal nail as close to the proximal edge as possible. Scrape the nail bed and underside of nail plate with a curet. Discard the outermost debris, which likely contains contaminants. Nail clippings are less desirable for culture.
• Proximal subungual: Pare down the normal surface of nail plate in the area of the lunula. Collect white material from the deeper portion of plate.
• White superficial: Scrape the white spots, discarding the outermost surface, which likely contains contaminants. Collect the white areas directly underneath.
• Candida infection: Collect material closest to the proximal and lateral nail edges.
Hair: Epilate 10 to 12 hairs and place them in a sterile container.
Swabs: Throat, nose, nasopharynx, and ear swabs are acceptable; material from the ear is better than a swab.
Urine: Clean catch midstream sample in sterile container.
Wound: Aspirate of purulent material or fluid, scraping of lesion border, or swab (least preferred) in sterile container. Swabs cannot be split for other tests.
Avoid contamination of the specimen with commensal organisms as much as possible. Specify the source of the specimen and include any pertinent clinical information. Cultures are incubated one to four weeks (depending on source) before a final negative report is issued.
Storage Instructions
Refrigerate nonsterile respiratory specimens; all others should be maintained at room temperature.
Patient Preparation
Usual sterile preparation (see Blood Culture, Routine [008300]).
Causes for Rejection
Unlabeled specimen or name discrepancy between specimen and request label; specimen submitted in syringe with needle attached; specimen received after prolonged transport (usually more than 72 hours); lithium heparin tube; stool; swab without evidence of specimen present; specimen received after leaking transport container into specimen bag (Trach-suction devices will often leak if the cap with tubing is not removed and replaced by solid cap. If tubing cannot be replaced by a solid cap, the specimen should be transferred to a leakproof sterile cup with a screwcap); inappropriate transport device
References
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 008482 | Fungus (Mycology) Culture | 580-1 | 008482 | Fungus (Mycology) Culture | 580-1 | |
| Order Code | 008482 | |||||
| Order Code Name | Fungus (Mycology) Culture | |||||
| Order Loinc | 580-1 | |||||
| Result Code | 008482 | |||||
| Result Code Name | Fungus (Mycology) Culture | |||||
| UofM | ||||||
| Result LOINC | 580-1 |
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 080092 | Result | 080094 | Result 1 | 580-1 | |
| Reflex 1 | ||||||
| Order Code | 080092 | |||||
| Order Name | Result | |||||
| Result Code | 080094 | |||||
| Result Name | Result 1 | |||||
| UofM | ||||||
| Result LOINC | 580-1 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 080092 | Result | 080095 | Result 2 | 17947-3 | |
| Reflex 1 | ||||||
| Order Code | 080092 | |||||
| Order Name | Result | |||||
| Result Code | 080095 | |||||
| Result Name | Result 2 | |||||
| UofM | ||||||
| Result LOINC | 17947-3 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 080092 | Result | 080096 | Result 3 | 17948-1 | |
| Reflex 1 | ||||||
| Order Code | 080092 | |||||
| Order Name | Result | |||||
| Result Code | 080096 | |||||
| Result Name | Result 3 | |||||
| UofM | ||||||
| Result LOINC | 17948-1 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 080092 | Result | 080097 | Result 4 | 17949-9 | |
| Reflex 1 | ||||||
| Order Code | 080092 | |||||
| Order Name | Result | |||||
| Result Code | 080097 | |||||
| Result Name | Result 4 | |||||
| UofM | ||||||
| Result LOINC | 17949-9 | |||||
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
|---|---|---|---|---|---|---|
| Reflex 1 | 080092 | Result | 080098 | Antimicrobial Susceptibility | N/A | |
| Reflex 1 | ||||||
| Order Code | 080092 | |||||
| Order Name | Result | |||||
| Result Code | 080098 | |||||
| Result Name | Antimicrobial Susceptibility | |||||
| UofM | ||||||
| Result LOINC | N/A | |||||