Skin Culture, Fungus

CERNER / EPIC MNEMONIC:

C SFUNGUSSM; C SFUNGUS (culture) or C SFUNSM (cult with smear)

POE DESCRIPTION: CU FUNGUS SMEAR (SKIN ONLY); C SFUNSM
CPT CODE: 87101; 87206
TEST INFORMATION: Test includes a culture for fungi and performance of a direct fungal smear. All fungal isolates will be identified. Other isolated organisms (i.e. aerobes, mycobacteria, 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: Smear results: same day if the specimen is received in the laboratory no later than 1400. Preliminary culture reports are available after 1 week or when a fungal isolate is detected. Cultures will be finalized after 4 weeks.
SPECIAL INSTRUCTIONS: The specific anatomic site of the specimen MUST be specified on the requisition or order with surface and/or deep or surgical biopsies delineated.
CONTAINER TYPE: Sealed sterile container, no preservative; sterile Petri dish (available from Clinical Microbiology Laboratory)
COLLECTION: Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface organisms. Infected hair should be cut with sterile scissors or plucked with sterile forceps and placed in a sealed, sterile container. A Wood`s lamp is useful in the collection of specimens in tinea capitis infections, since hairs infected by most members of the genus Microsporum exhibit fluorescence under a Wood`s lamp. If diseased hair stubs or fluorescent hairs are not apparent, scrape the edge of a scalp lesion with a sterile scalpel. Infected nails should be sampled from beneath the nail to obtain softened material from the nail bed. If unable to obtain adequate material from the nail bed, a scalpel should be utilized to scrape the superficial portions of the nail obtaining subsurface material. Nail clippings are unacceptable. When obtaining a cutaneous specimen, the area to be sampled should first be cleansed with 70% alcohol to remove bacterial contaminants. Typical ''ringworm'' lesions should be sampled from the erythematous, peripheral growing margin.
SPECIMEN REQUIREMENTS: Hair, nail scrapings, skin scrapings
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, refrigerated specimen, specimen received in a preservative, nail clippings.
MINIMUM VOLUME: As much as possible
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
REFERENCE RANGE: No fungi observed/isolated
LIMITATIONS OF TEST: The Calcofluor white stain demonstrates yeast forms, spores, and the hyphae of fungi. The filaments of Nocardia species, Streptomyces species, and Actinomyces species, as well as, the capsule of Cryptococcus species are NOT satisfactorily demonstrated with this methodology.
METHODOLOGY: Fungal smear: calcofluor white stain. Culture: Conventional culture utilizing media specifically formulated for fungal isolation.
LAST UPDATED:

5-27-2014

TEST SYNONYM(S):Fungus Culture, Skin