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Test Code SOFT: Z1000 Fungal Smear, Varies

Additional Codes

Ordering MnemonicMayo Test ID
HOM: MISC LABFS

Reporting Name

Fungal Smear

Useful For

Detection of fungi in clinical specimens

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
TISSR Tissue Processing No, (Bill Only) No

Testing Algorithm

For information, see Meningitis/Encephalitis Panel Algorithm.

Method Name

Calcofluor/KOH Stain

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

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

 

Specimen Type: Urine

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions: Collect a random urine specimen.

 

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 Minimum Volume

Bone marrow, body fluid, or respiratory specimen: 0.2 mL; Any other specimen type: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 7 days
  Ambient  7 days

Reject Due To

Blood or fixed tissue
Specimen in viral transport (including but not limited to M4, M5, BD viral transport media, thioglycolate broth)
Nasal swab
Wood shaft or charcoal swab
Catheter tips
Prepared slide, glass slide, microscope slide
Stool
Reject
 

Reference Values

Negative

Day(s) Performed

Monday through Sunday

CPT Code Information

87206

87176-Tissue processing (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FS Fungal Smear 658-5

 

Result ID Test Result Name Result LOINC Value
FS Fungal Smear 658-5

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.

Clinical Information

Many fungi in the environment cause disease in severely compromised 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.

 

Few fungal diseases can be diagnosed clinically; most are diagnosed by isolating and identifying the infecting fungus in the clinical laboratory.

Interpretation

Positive slides are reported as one or more of the following: yeast or hyphae present, organism resembling Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides immitis, Cryptococcus neoformans, or Malassezia furfur.

Cautions

No significant cautionary statements.

Clinical Reference

1. Schelenz S, Barnes RA, Barton RC, et al. British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases. Lancet Infect Dis. 2015;15(4):461-474. doi:10.1016/S1473-3099(15)70006-X

2. Hoenigl M, Salmanton-García J, Walsh TJ, et al. Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology [published correction appears in Lancet Infect Dis. 2021 Apr;21(4):e81]. Lancet Infect Dis. 2021;21(8):e246-e257. doi:10.1016/S1473-3099(20)30784-2

Method Description

Calcofluor white, a fluorescent textile brightener, nonspecifically binds with chitin in the cell wall of fungi. Examination of stained specimens using fluorescent microscopy allows for the detection of fungi due to the fluorescence of calcofluor white present on the fungal cell wall. Potassium hydroxide is added to hasten clearing of viscous specimens, and Evans blue is added to prevent nonspecific fluorescence.(Lindsley M. Mycology: Reagents, stains, and media. In: Carroll KC, Pfaller MA, Pritt BS, et al. Manual of Clinical Microbiology. 13th ed. ASM Press; 2023)

Report Available

1 to 2 days

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Secondary ID

84390

Specimen Retention Time

Raw specimen: 7 days