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Fungal Culture

Athlete’s Foot, Tinea, Ringworm, Mold, Mould, Fungal Culture

Test Codes

EPIC: LAB240

Department

Microbiology

Instructions

• If the specimen source is blood, please see Fungal Blood Culture.  If the specimen source is hair, skin, or nails, please see Fungal Hair, Skin, Nail Culture.  
• Swabs are the least optimal means of submitting specimens for fungal testing and tissue or fluid should always be collected, when possible. If a swab is the only means of specimen collection, an Eswab must be used. The only acceptable sources for swabbed collections are dermal, ear, mouth, ocular, throat, or wounds.
• If mucormycosis is suspected, call the Microbiology Lab at 248-551-8090 to inform them of this. These specimens cannot be ground or minced, as it may decrease the viability of these organisms.

Specimen Collection Criteria

Collect: Fungal specimens using aseptic technique, placed into a sterile collection container. Specimen sources and collection instructions are listed below.

• Body fluids: Collect specimen aseptically. Place a minimum of 2.0 mL in a sterile collection container.
• Bone Marrow:
  • Acceptable:
  • Sterile tubes containing SPS:
  • Can be used for bacterial, fungal, and mycobacterial culture.
  • Fastidious organisms such as Streptococcus pneumoniae may be inhibited from growth.
  • Sterile tubes containing Lithium or Sodium Heparin:
  • Can be used for fungal and mycobacterial cultures.
  • Can not be used for bacterial culture.
  • Sterile, screw-capped tubes (not recommended):
  • Can be used for bacterial, fungal, and mycobacterial cultures.
  • The bone marrow will clot and will need to be ground prior to culture. This may adversely affect the ability to recover microorganisms (especially fungi).
  • Bronchoscopy specimens [Bronchial brushings, biopsies, bronchial washes, bronchoalveolar lavage (BAL)]: Place specimen in a sterile collection container.
  • Cerebrospinal Fluid (CSF): Collect spinal fluid (1-2 mL) and place it into a sterile collection container.
  • Eye: Eye cultures are best done when the medium is directly inoculated by the ophthalmologist. Corneal scrapings can be transferred to a BAP or SAB agar using a series of C-shaped cuts into the medium. Intra-ocular fluid can be placed in a sterile tube and transported to the laboratory. Swabs acceptable for conjunctiva.
  • Pus, exudates, drainage and miliary abscesses: Aspirate material from undrained abscesses. Place material in a sterile collection container. Collection via Eswab is acceptable but strongly discouraged as swab collection offers a much lower yield compared to aspirated material in sterile cup.
  • Sinus Contents: Aspirate material or tissue from sinus collected in a sterile container (a Lukens Trap is acceptable for aspirates) is preferred. If a swabbed collection must be performed, only collect using an Eswab.
  • Sputum: Collect approximately 5-10 mL of an early morning specimen and place into a sterile collection container.
  • Tissue: Collect tissue aseptically from center and edge of lesion. Place specimen in a sterile collection container. Add 0.5 mL sterile, non-bacteriostatic saline to the container.
  • NOTE: If mucormycosis is suspected, call the Microbiology Lab at 248-551-8090 to notify them. Grinding and mincing these specimens may decrease the viability of these organisms.
  • Urine: Collect the first early morning clean-catch midstream specimen, collected into a Gray-top Boric Acid urine transport tube. 
  • Vaginal Material: For detection of yeast vaginitis, collect material from the vagina and place swab into an Affirm transport tube. See Vaginitis PCR Panel.  If specific identity of yeast is required, submit ESwab of vaginal secretions in Amies transport medium.

Physician Office/Draw Specimen Preparation

• All sterile site specimens should be delivered to the Laboratory immediately. Maintain specimens at room temperature prior to transport.
• All non-sterile site specimens (other than hair, skin, or nails) should be refrigerated (2-8°C or 36-46°F) immediately after collection and maintained refrigerated until transport.

Preparation for Courier Transport

Transport: Sterile site specimens, at room temperature (20-26°C or 68-78.8°F), and non-sterile site specimens (other than hair, skin, or nails), refrigerated, 2-8°C or 36-46°F).

Rejection Criteria

• Swabs, other than those specifically listed above, and swabs not in an approved commercial Amies transport system.
• Unlabeled specimens.
• Insufficient volume, determined by specimen source.
• 24-hour sputum or urine samples.
• Specimens received in leaking containers.

Inpatient Specimen Preparation

Specimens must be transported to the Laboratory immediately after collection for optimal recovery. If specimen transport is delayed, specimens can be maintained refrigerated prior to transport.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 72 hours
Refrigerated (2-8°C or 36-46°F): 7 days for all other sources.
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days for non-sterile site specimens, 30 days for sterile site specimens.

Laboratory

Royal Oak Microbiology Laboratory

Performed

Monday – Friday, 7:00 am – 3:30 pm.
Preliminary results available within 72 hours.

Reference Range

No growth.

Test Methodology

Fungal culture, microscopy, phenotypic tests, mass spectrometry and biochemical tests for identification of organisms.

Clinical Utility

Identification of fungi in clinical specimens may aid the physician in diagnosing and treating a patient.

Reference

1. Hazen, K.C., and S.A. Howell, 2016. Specimen Selection, Collection and Transport, Leber, A.L., Editor-in-Chief, Clinical Microbiology Procedures Handbook, 4^th Edition. ASM Press. Washington, D.C.

CPT Codes

87101, 87102, or 87103, dependent on source.
LOINC:  580-1

Contacts

Last Updated

8/28/2025