Blood Culture, Fungus

CPT CODE: 87103
TEST INFORMATION: The test includes isolation and identification of any fungi isolated. Other isolated organisms (i.e. aerobes, etc.) may be referred for identification and/or susceptibility testing if medically indicated AND a separate culture procedure has NOT yielded the same organism(s).
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Preliminary culture reports are available after 1 week or when an isolate is detected. Cultures will be finalized after 2 weeks.
SPECIAL INSTRUCTIONS: Request test specifically. Not a component of a routine blood culture. The specific site of the specimen (i.e. arterial, swan ganz, etc.) MUST be specified on the order or requisition.
CONTAINER TYPE: Inpatients:  BD Bactec Myco/F Lytic bottle (available from Clinical
Microbiology, 312-942-5452); Clients: yellow top SPS Vacutainer®
(available from Client Services, 312-942-4942).
COLLECTION: Swab the venipuncture site concentrically, starting at the center, with 4% chlorhexidine glucosate. After the disinfectant has dried, remove with an alcohol swab. The venipuncture site must not be palpated after preparation. Obtain 5 mL blood (adults)  1 mL (children). Inoculate the collection tube. Invert the tube 5-10 times to mix well. Blood cultures should be obtained prior to initiation of antifungal therapy. If more than one culture is ordered, the specimen should be obtained from separate venipuncture sites.  Disinfect the septum of the collection tube with alcohol. The time of collection must be indicated. Strict aseptic technique is essential.
REJECTION CRITERIA: Inappropriate specimen container, specimen received more than 8 hours after collection, insufficient specimen volume, refrigerated specimen, clotted specimen.
MINIMUM VOLUME: Adult: 3 mL; pediatric 1 mL
HANDLING INSTRUCTIONS: Blood cultures should be transported as soon as possible. When transportation is delayed, leave at room temperature. Do NOT refrigerate.
REFERENCE RANGE: No fungi isolated; no growth
LIMITATIONS OF TEST: Routine blood cultures aer generally adequate for recovery of Candida spp. Fungal Blood Cultures are most effective in isolating Candida albicans and other yeasts. If other fungal species are suspected, a biopsy or bone marrow submitted for Fungus Culture should be considered.
METHODOLOGY: Lysis centrifugation followed by inoculation of conventional media specifically formulated for fungal isolation.
ADDITIONAL INFORMATION: If Malassezia furfur is suspected, this must be indicated on the order or the requisition. Bacterial isolates will be referred to the Blood Culture workstation for identification and susceptibility testing, when appropriate. An additional charge(s) will be incurred. Mycobacterial isolates will be referred to the Mycobacteriology laboratory for identification and susceptibility testing, when appropriate. An additional charge(s) will be incurred.
TEST SYNONYM(S):Fungus Culture, Blood; Fungus, Blood Culture