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HelpTest Code FS Fungal Smear, Varies
Reporting Name
Fungal SmearUseful For
Detection of fungi in clinical specimens
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
VariesShipping 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 Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Refrigerated (preferred) | 7 days |
| Ambient | 7 days |
Reference Values
Negative
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
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 |
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-GarcÃa 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 daysReject 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 |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| TISSR | Tissue Processing | No, (Bill Only) | No |
Specimen Minimum Volume
Bone marrow, body fluid, or respiratory specimen: 0.2 mL; Any other specimen type: See Specimen Required
Method Name
Calcofluor/KOH Stain
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Secondary ID
84390Specimen Retention Time
Raw specimen: 7 daysTesting Algorithm
For information, see Meningitis/Encephalitis Panel Algorithm.