Sputum Culture, Fungus

CERNER / EPIC MNEMONIC: C FUNGUSSM
POE DESCRIPTION: CU FUNGUS W SMEAR(NON-SKIN); C FUNGUSSM (NON-SKIN)
CPT CODE: 87102; 87206
TEST INFORMATION: Test includes a culture for fungi and performance of a direct fungal smear. All fungal isolates will be identified except for yeast that have the morphologic appearance of Candida Spp. and that have been shown not  to be Cryptococcus spp.  Such yeast will be identified only as, 'Candida species, not cryptoccus.' 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. Cultures are examined Monday-Saturday.
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. Culture reports will be finalized after 4 weeks.
SPECIAL INSTRUCTIONS: The specific anatomic site of the specimen MUST be specified on the requisition or order.
CONTAINER TYPE: Sterile sputum container; sterile Leuken`s tube; sealed, sterile container, no preservative
COLLECTION: The sputum and Leuken`s specimens should be first morning specimens. Nonbacteriostatic saline should be used when irrigation is necessary. The gastric aspirate is to be collected utilizing aseptic technique. The patient should NOT have eaten within the previous 5 hours when obtaining a gastric aspirate.
SPECIMEN REQUIREMENTS: First morning sputum, induced sputum, aspirated sputum, tracheal aspirate, bronchial, Leuken`s, gastric aspirate
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, specimen received in a preservative.
MINIMUM VOLUME: 2 mL
HANDLING INSTRUCTIONS: Gastric aspirates should be transported immediately. Specimens 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.
ADDITIONAL INFORMATION: Gastric aspirates are frequently diluted with saline. Please notify the Clinical Microbiology Laboratory (312-942-5452) if Histoplasma capsulatum, Blastomyces dermatitidis, or Coccidioides immitis is suspected. These pathogens are highly infectious when propagated in vitro and have been associated with serious infections in exposed laboratory workers.
TEST SYNONYM(S):Gastric Aspirate Fungus Culture