Culture, Fungus (Mycology)
Biopsy, blood, body fluid, aspirates, bronchoalveolar lavage (BAL), swab of conjunctiva, skin, nails, hair, sputum, stool, throat, tissue, urine or vaginal
Sterile container for fluid or tissue or green-top (sodium heparin) tube, blood culture bottle, Para-Pak White for stool
Biopsy: Surgical specimen in sterile container. A small amount of sterile nonbacteriostatic water should be added to prevent drying.
Body fluid, aspirates: Aspirated material in sterile container.
Eye: For keratitis, scrapings with a Kimura spatula directly inoculated using “C” streaks are best.
Skin: Cleanse the area with 70% alcohol and collect a portion from the active border of the lesion.
Nails: For all types of onychomycosis, clean the nail area well with 70% alcohol, then, depending on type of nail disease, collect the following in a sterile container:
• Distal subungual: Clip the abnormal nail as close to the proximal edge as possible. Scrape the nail bed and underside of nail plate with a curet. Discard the outermost debris, which likely contains contaminants. Nail clippings are less desirable for culture.
• Proximal subungual: Pare down the normal surface of nail plate in the area of the lunula. Collect white material from the deeper portion of plate.
• White superficial: Scrape the white spots, discarding the outermost surface, which likely contains contaminants. Collect the white areas directly underneath.
• Candida infection: Collect material closest to the proximal and lateral nail edges.
Hair: Epilate 10 to 12 hairs and place them in a sterile container.
Stool: Random sample in sterile container.
Swabs: Throat, nose, nasopharynx, and ear swabs are acceptable; material from the ear is better than a swab.
Urine: Clean catch midstream sample in sterile container.
Wound: Aspirate of purulent material or fluid, scraping of lesion border, or swab (least preferred) in sterile container. Swabs cannot be split for other tests.
Room temp: 72 hours
Isolate and identify fungi. Blood: establish the diagnosis of fungal infections including fungemia, fungal endocarditis, and disseminated mycosis in patients at risk for fungal infections.