Acid-Fast Stain, Modified for Nocardia

CERNER / EPIC MNEMONIC: SM FUNGUS
POE DESCRIPTION: SM FUNGUS
CPT CODE: 87026
TEST INFORMATION: Use to determine the presence or absence of organisms resembling Nocardia species which are generally acid-fast when stained by the modified acid-fast stain. Actinomyces species and Streptomyces species which may be microscopically similar to Nocardia species on Gram stain are not acid-fast with the modified acid-fast stain.
DAYS PERFORMED: Monday - Saturday, 0700-1430
TURNAROUND TIME: Same day if received before 1430
SPECIAL INSTRUCTIONS: Order or requisition MUST state smear for Nocardia. The specific anatomic site of the specimen MUST be specified on the order or requisition.
CONTAINER TYPE: Sealed, sterile container
COLLECTION: The specimen of choice is an aspirate, tissue, or lower respiratory specimen. Specimens are to be collected from a site prepared utilizing aseptic technique. Swabs should be used as a last resort.
SPECIMEN REQUIREMENTS: Pus or other purulent fluid material appropriately obtained from a wound; lower respiratory specimen.
REJECTION CRITERIA: Inappropriate specimen container; insufficient specimen volume.
MINIMUM VOLUME: 2 mL
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No acid-fast organisms resembling Nocardia species observed.
LIMITATIONS OF TEST: Nocardia species occasionally do NOT stain acid-fast with the Modified Acid-Fast stain.
METHODOLOGY: Modified Ziehl-Neelsen stain
ADDITIONAL INFORMATION: Specimens from lesions suspected of containing Nocardia species should also be examined for fungi, mycobacteria, and Actinomyces species. Separate specimens should be submitted for Fungus Culture, Mycobacterium Culture, and Actinomycosis Special Anaerobic Culture.
TEST SYNONYM(S):Nocardia, Acid-Fast Stain; Modified Acid-Fast Stain, Nocardia