Fungal Culture and Smear

1. Collect specimen aseptically, place in sterile container, deliver container to laboratory within 2 hours, process specimen, and inoculate specimen to primary isolation media within a few hours of collection. Viability may decrease with prolonged specimen storage.

2. Swab is not encouraged; however, specimen from certain body sites such as ear canal, nasopharynx, throat, vagina, and cervix, are not readily collected by other means. Swab for collection of material from open wound or draining lesion are frequently contaminated with environmental microorganisms.

 

Body Fluid (Peritoneal, Pleural, and Synovial)

1. Aseptically collect specimen.

2. Place specimen in a screw-capped, sterile container.

3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Bone Marrow
1. Aspirate approximately 3 mL to 5 mL of bone marrow.

2. Place specimen in a screw-capped, sterile container. Sodium polyethanol sulfonate (SPS) or heparin can be added as an anticoagulant.

3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Eye
1. Specimen must be obtained by ophthalmologist or in operating room.

2. Scrape surface of cornea several times. Use a scalpel to inoculate fungal media and prepare slide for fungal stain.

3. Label media and slide with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Hair
1. No cleaning of scalp is needed.

2. Select infected areas and, with forceps, epilate at least 10 hairs.

3. For hair broken off at scalp level, use a scalpel or blade knife.

4. Place hair between 2 clean, glass slides or in an envelope.
5. Label slides/envelope with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
6. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Miliary Abscess
1. Using a sterile, sharp-pointed scalpel, express pus.

2. Place specimen in a screw-capped, sterile container.

3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Nail
1. Clean nail with 70% alcohol.
2. For a specimen of dorsal plate, scrape outer surface and discard scraping. Then scrape deeper portion for a specimen.
3. Remove a portion of debris from under nail with a scalpel.

4. Collect whole nail or nail clipping.

5. Place all material in a clean envelope.

6. Label envelope with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
7. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Pus, Exudate, and Drainage
1. Using a sterile needle and syringe, aspirate material from undrained abscess.

2. Place specimen in a screw-capped, sterile container.

3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Respiratory Specimen Other Than Sputum
1. Physician should aseptically collect tracheal aspirate, lung biopsy material, or bronchoscopy specimen.

2. Place specimen in a screw-capped, sterile container.
3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Skin and Interspace

1. Wipe lesion and interspace between toes with alcohol sponge or sterile water.

2. Scrape entire lesion and both sides of interspaces with a sterile scalpel.

3. Place scraping between 2 clean, glass slides or in a clean envelope.

4. Label slides/envelope with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

5. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Spinal Fluid

1. Collect as much spinal fluid as possible.

2. Place specimen in a screw-capped, sterile container. Generally, a #3 tube is used from a series of 3 tubes.

3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.

4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Sputum (Aerosol Collection, Bronchial Lavage, and Tracheal Lavage)
1. Collect an early-morning specimen. Sputum should be fresh.

2. Have patient remove dentures and rinse mouth.

3. Sputum should be the result of a deep-cough (not saliva) or should be induced by an aqueous aerosol.

4. Collect 5 mL to 10 mL of sputum in a screw-capped, sterile container.

5. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
6. Maintain sterility and forward promptly.
Note:  Specimen source is required on request form for processing.

Stool

1. Collect stool by rectal swab or a fresh stool specimen.

2. Place rectal swab in a culture transport tube or a fresh stool specimen in a screw-capped, sterile container.

3. Label tube/container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
4. Maintain sterility and forward promptly.

Note:  Specimen source is required on request form for processing.

Tissue
1. Collect tissue aseptically from center and edge of lesion.

2. Place tissue between moist gauze squares, add a small amount of sterile water or 0.85% saline to keep tissue from drying out, and transport in a screw-capped, sterile container.

3. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
4. Maintain sterility and forward promptly. Keep refrigerated for no more than 8 hours at 4° C until processed.
Note:  Specimen source is required on request form for processing.

Urine

Urine specimen most suitable for making a diagnosis of mycoses of urinary tract is a catherized specimen. Collect a clean-catch, midstream specimen when aspiration or cytoscopy cannot be done.

1. Collect an early-morning urine specimen aseptically in a screw-capped, sterile container. 24-Hour collection is not recommended. It offers no advantages over early-morning specimens.

2. Label container with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
3. Maintain sterility and forward promptly. Urine may be stored at 4° C for 12 to 14 hours.
Note:  Specimen source is required on request form for processing.

Vaginal Material
1. Collect specimen from vagina using a double-swab tube system.
2. Label tubes with patient’s name (first and last), medical record number (if available), date and time of collection, and type of specimen.
3. Maintain sterility and forward promptly.
Note:  Specimen source is required on request form for processing.

Process specimens and inoculate them to primary isolation media as soon as possible after collection, ideally within a few hours. Limited studies have shown significantly decreased viability for Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, and Aspergillus fumigatus stored at ambient temperature or on dry ice. Rhizopus arrhizus is also known to be difficult to recover from delayed specimens. Do not assume that successful methods for storage of fungal cultures are suitable for temporary storage of clinical specimens that harbor relatively few fungal cells.

The effect of refrigeration on fungal specimens has not been well studied, but if processing is to be delayed for more than several hours, store the specimens under refrigeration at 4° C with the following exceptions:  store blood and CSF at 30° C to 37° C, and store dermatological specimens at 15° C to 30° C.