Table XII-6.
Laboratory Diagnosis of Fungal Infections of Skin and Subcutaneous Tissue
| Etiologic Agents | Diagnostic Procedures | Optimum Specimens | Transport Issues; Optimal Transport Times |
|---|---|---|---|
| Dermatophytes/Tineas | |||
| Epidermophyton spp | Fungal culture | Skin scrapings/hair follicles/nail scrapings | Sterile transport container Aerobic conditions, RT, <4 h |
| Trichophyton spp | Calcofluor-KOH preparation | ||
| Microsporum spp | Histopathology | Tissue/biopsy | Formalin container, RT, 2 h–24 h |
| Dematiaceous (darkly pigmented) Filamentous Fungi | |||
| Scedosporium/ | Fungal culture | Tissue/biopsy/aspirate | Sterile transport container |
| Pseudallescheria spp | Calcofluor-KOH preparation | Aerobic conditions, RT, <2 h | |
| Exophiala spp | |||
| Cladosporium spp | Histopathology | Tissue/biopsy/aspirate | Formalin container, RT, 2 h–24 h |
| Phialophora spp | |||
| Alternaria spp | |||
| Bipolaris spp | |||
| Dimorphic | |||
| Histoplasma capsulatum | Fungal culture | Tissue/biopsy/aspirate | Sterile transport container |
| Blastomyces dermatitidis | Urine Antigen (Histoplasma; Blastomyces) | Urine | Aerobic conditions |
| Coccidioides immitis | Sterile cup; RT <2 h | ||
| Paracoccidioides brasiliensis | |||
| Penicillium marneffei | Calcofluor-KOH preparation | ||
| Sporothrix schenckii | Fungal serology | Serum | Clot tube, RT, <2 h |
| Blood culture | Blood; 2 sets | Aerobic blood culture bottles, RT, <2 h | |
| Histopathology | Tissue/biopsy/aspirate | Formalin container, RT, 2 h–24 h | |
| Yeast-like Fungi | |||
| Candida spp | Fungal culture | Tissue/biopsy/aspirate | Sterile transport container |
| Cryptococcus neoformans | Calcofluor-KOH preparation stain | Blood; 2 sets | Aerobic conditions |
| Trichosporon spp | RT, <2 h | ||
| Geotrichum spp | Aerobic blood culture bottles, RT, <2 h | ||
| Malassezia spp | Blood culture | Blood; 2 sets | Aerobic blood culture bottle or lysis/centrifugation blood culture, RT, <2 h |
| Histopathology | Tissue/biopsy/aspirate | Formalin container, RT, 2 h–24 h | |
| Other Fungi | |||
| Aspergillus spp | Fungal culture | Tissue/biopsy/aspirate | Sterile transport container |
| Fusarium spp | Calcofluor-KOH preparation | Aerobic conditions | |
| Zygomycetes | Blood; 2 sets(Fusarium only) | RT, <2 h | |
| Aerobic blood culture bottles or lysis/centrifugation blood cultures, RT, <2 h | |||
| Histopathology | Tissue/biopsy/aspirate | Formalin container, RT, 2 h–24 h | |
Abbreviations:KOH, potassium hydroxide; RT, room temperature.