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HelpTest Code FGEN Fungal Culture, Routine
Reporting Name
Fungal Culture, RoutineUseful For
Diagnosing fungal infections from specimens other than blood, skin, hair, nails, and vagina (separate tests are available for these specimen sites)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
VariesOrdering Guidance
Nocardia and the other aerobic actinomycetes are not fungi, therefore a fungal culture should not be ordered. However, these organisms grow well on mycobacterial medium. When infection with this group of organisms is suspected, order CTB / Mycobacteria and Nocardia Culture, Varies.
Shipping Instructions
Specimen should arrive within 24 hours of collection.
Necessary Information
Specimen source is required.
Specimen Required
Preferred Specimen Type: Body fluid
Container/Tube: Sterile container
Specimen Volume: Entire collection
Preferred Specimen Type: Fresh tissue
Container/Tube: Sterile container
Specimen Volume: Pea size
Collection Instructions: Tissue should be placed in small amount of sterile saline or sterile water.
Specimen Type: Bone marrow
Container/Tube: Sterile container, SPS/Isolator system, or green top (lithium or sodium heparin)
Specimen Volume: Entire collection
Specimen Type: Respiratory specimen
Container/Tube: Sterile container
Specimen Volume: Entire collection
Acceptable Specimen Type: Swab
Sources: Dermal, ear, mouth, ocular, throat, or wound
Container/Tube: Culture transport swab (non-charcoal) Culturette or ESwab
Specimen Volume: Swab
Collection Instructions:
1. Before collecting specimen, wipe away any excessive amount of secretion and discharge, if appropriate.
2. Obtain secretions or fluid from source with sterile swab.
3. If smear and culture are requested or both a bacterial culture and fungal culture are requested, collect a second swab to maximize test sensitivity.
Specimen Type: Urine
Container/Tube: Sterile container
Specimen Volume: 2 mL
Collection Instructions: Collect a random urine specimen.
Specimen Minimum Volume
Bone marrow or body fluid: 1 mL; Cerebrospinal fluid: 0.5 mL; Respiratory specimen: 1.5 mL; All other specimen types: See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Refrigerated (preferred) | 7 days |
| Ambient | 7 days |
Reference Values
Negative
If positive, fungus will be identified.
Day(s) Performed
Monday through Sunday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
87102-Fungal culture, routine
87106-Id MALDI-TOF Mass Spec Yeast (if appropriate)
87107-Id MALDI-TOF Mass Spec Fungi (if appropriate)
87107-Fungal identification panel A (if appropriate)
87107-Fungal identification panel B (if appropriate)
87150 x 2-Identification Histoplasma/Blastomyces, PCR (if appropriate)
87153-D2 fungal sequencing identification (if appropriate)
87176-Tissue processing (if appropriate)
87150- Id, Candida auris Rapid PCR (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| FGEN | Fungal Culture, Routine | 51723-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| FGEN | Fungal Culture, Routine | 51723-5 |
Clinical Information
Many fungi in the environment cause disease in immunocompromised human hosts. Accordingly, the range of potential pathogenic fungi has increased as the number of immunosuppressed individuals (persons with AIDS, patients receiving chemotherapy or transplant rejection therapy, etc) has increased. Isolation and identification of the infecting fungus in the clinical laboratory can help guide patient care.
Interpretation
Positive cultures of yeast and filamentous fungi are reported with the organism identification.
The clinician must determine whether the presence of an organism is significant or not. A final negative report is issued after 24 days of incubation.
Method Description
Specimens are cultured on selective fungal media (eg, inhibitory mold agar and brain heart infusion blood agar with chloramphenicol and gentamicin). Respiratory sources also are cultured on brain heart infusion agar with chloramphenicol, gentamicin, and cycloheximide. Cultures are incubated for 24 days at 30° C.
Identification of fungi is based on colonial and microscopic morphology, matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, laboratory-developed real-time polymerase chain reaction assays and/or D2 ribosomal RNA gene sequencing, as applicable.(Babady NE, Buckwalter SP, Hall L, Le Febre KM, Binnicker MF, Wengenack NL. Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real-time PCR. J Clin Microbiol. 2011;49(9):3204-3208; Binnicker MJ, Buckwalter SP, Eisberner JJ, et al. Detection of Coccidioides species in clinical specimens by real-time PCR. J Clin Microbiol. 2007;45(1):173-178; Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionization time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol. 2011;49[4]:1614-1616; Hall L, Wohlfiel SL, Roberts GD. Experience with the MicroSeq D2 large-subunit ribosomal DNA sequencing kit for identification of filamentous fungi encountered in the clinical laboratory. J Clin Microbiol. 2004;42(2):622-626; Theel ES, Schmidt BH, Hall L, et al. Formic acid-based direct, on-plate testing of yeast and Corynebacterium species by Bruker Biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2012;50(9):3093-3095; Theel ES, Hall L, Mandrekar J, Wengenack NL: Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2011;49(12):4067-4071; Fida M, Wengenack NL, Theel ES. Mycology: General approaches for direct and indirect detection and identification of fungi. In: Carroll KC, Pfaller MA, Pritt BS, et al. Manual of Clinical Microbiology. 13th ed. ASM Press; 2023)
Reject Due To
| Blood or fixed tissue Specimen in viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth) Swab sources of respiratory fluids (eg, sputum) or nasal swab Wood shaft or charcoal swab Catheter tips Petri dish Stool Blades from scalpels or razors |
Reject |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| D2F | D2 Fungal Sequencing Identification | No, (Bill Only) | No |
| FUNA | Fungal Ident Panel A | No, (Bill Only) | No |
| FUNB | Fungal Ident Panel B | No, (Bill Only) | No |
| LCCI | Ident Rapid PCR Coccidioides | No, (Bill Only) | No |
| LCHB | Id, Histoplasma/Blastomyces PCR | No, (Bill Only) | No |
| RMALF | Id MALDI-TOF Mass Spec Fungi | No, (Bill Only) | No |
| TISSR | Tissue Processing | No, (Bill Only) | No |
| RMALY | Id MALDI-TOF Mass Spec Yeast | No, (Bill Only) | No |
| LCCA | Id, Candida auris Rapid PCR | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex tests may be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Method Name
Conventional Agar Culture/Macroscopy/Microscopy/D2 rDNA Gene Sequencing/Real-Time Polymerase Chain Reaction (rtPCR)/Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS)
Dimorphic Pathogen Identification Confirmation: D2 rDNA Gene Sequencing/rtPCR/MALDI-TOF MS
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.