Test Id : FS
Fungal Smear, Varies
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Detection of fungi in clinical specimens
    
        Reflex Tests
            
                
                
                    
                    Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
                
            
    
    | Test Id | Reporting Name | Available Separately | Always Performed | 
|---|---|---|---|
| TISSR | Tissue Processing | No, (Bill Only) | No | 
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    For information, see Meningitis/Encephalitis Panel Algorithm.
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Calcofluor/KOH Stain
    
        NY State Available
            
                
                
                    
                    Indicates the status of NY State approval and if the test is orderable for NY State clients.
                
            
    
    
    
        Reporting Name
            
                
                
                    
                    Lists a shorter or abbreviated version of the Published Name for a test
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    KOH stain
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    For information, see Meningitis/Encephalitis Panel Algorithm.
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Varies
    
        Shipping Instructions
    
    Specimen should arrive within 24 hours of collection.
    
        Necessary Information
    
    Specimen source is required.
    
        ORDER QUESTIONS AND ANSWERS
    
    | Question ID | Description | Answers | 
|---|---|---|
| Q00M0023 | Specimen Source | 
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Submit only 1 of the following specimens:
Preferred:
Specimen Type: Body fluid
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen Type: Fresh tissue
Container/Tube: Sterile container
Specimen Volume: Pea size
Collection Instructions: Tissue should be placed in small amount of sterile saline or sterile water.
Acceptable:
Specimen Type: Bone marrow
Container/Tube: Sterile container, SPS/Isolator system, or green top (lithium or sodium heparin)
Specimen Volume: Entire collection
Specimen Type: Respiratory specimen
Container/Tube: Sterile container
Specimen Volume: Entire collection
Specimen Type: Urine
Container/Tube: Sterile container
Specimen Volume: 2 mL
Collection Instructions: Collect a random urine specimen.
Fresh tissue or body fluid are preferred over a swab specimen. Recovery of mycobacteria from swabs is generally very low yield. Only submit a swab specimen if tissue biopsy or fluid aspiration is not possible.
Specimen Type: Swab
Supplies: BD E-swab (T853)
Sources: Dermal, ear, mouth, ocular, throat, or wound
Container/Tube: Sterile, screw-capped tube containing Liquid Amies Medium with flocked swab (eg, E-Swab)
Specimen Volume: Flocked swab in 1 mL of Liquid Amies Medium
Collection Instructions:
1. Before collecting specimen, wipe away any excessive amount of secretion and discharge, if appropriate.
2. Obtain secretions or fluid from source with sterile flocked swab.
3. Place flocked swab in sterile, screw-capped tube containing 1 mL of Liquid Amies Medium.
4. If smear and culture are requested or both a bacterial culture and fungal culture are requested, collect a second swab to maximize test sensitivity. Submit each swab in a separate sterile, screw-capped tube with 1 mL of Liquid Amies Medium.
    
        Special Instructions
            
                
                
                    
                    Library of PDFs including pertinent information and forms related to the test
                
            
    
    
            
    
        Forms
    
    If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    Bone marrow, body fluid, or respiratory specimen: 0.2 mL; Any other specimen type: See Specimen Required
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | Blood or fixed tissue Specimen in viral transport (including but not limited to M4, M5, BD viral transport media, thioglycolate broth) Nasal swab Wood shaft or charcoal swab Catheter tips Prepared slide, glass slide, microscope slide Stool Boric acid tube Aptima swab Culture transport swab (eg, Culturette) | Reject | 
    
        Specimen Stability Information
            
                
                
                    
                    Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
                
            
    
    | Specimen Type | Temperature | Time | Special Container | 
|---|---|---|---|
| Varies | Refrigerated (preferred) | 7 days | |
| Ambient | 7 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Detection of fungi in clinical specimens
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    For information, see Meningitis/Encephalitis Panel Algorithm.
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    Many fungi in the environment cause disease in severely compromised human hosts. Accordingly, the range of potential pathogenic fungi has increased as the number of immunosuppressed individuals (persons with AIDS, patients receiving chemotherapy or transplant rejection therapy, etc) has increased.
Few fungal diseases can be diagnosed clinically; most are diagnosed by isolating and identifying the infecting fungus in the clinical laboratory.
    
        Reference Values
            
                
                
                    
                    Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
                
            
    
    Negative
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    Positive slides are reported as one or more of the following: fungal elements seen, yeast, yeast and psuedohyphae, hyphae, organism resembling Blastomyces species complex, organism resembling Coccidioides species, hyphae resembling Mucorales, or organism resembling Malassezia species.
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    No significant cautionary statements
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Schelenz S, Barnes RA, Barton RC, et al. British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases. Lancet Infect Dis. 2015;15(4):461-474. doi:10.1016/S1473-3099(15)70006-X
2. Hoenigl M, Salmanton-García J, Walsh TJ, et al. Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology [published correction appears in Lancet Infect Dis. 2021 Apr;21(4):e81]. Lancet Infect Dis. 2021;21(8):e246-e257. doi:10.1016/S1473-3099(20)30784-2
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    Calcofluor white, a fluorescent textile brightener, nonspecifically binds with chitin in the cell wall of fungi. Examination of stained specimens using fluorescent microscopy allows for the detection of fungi due to the fluorescence of calcofluor white present on the fungal cell wall. Potassium hydroxide is added to hasten clearing of viscous specimens, and Evans blue is added to prevent nonspecific fluorescence.(Lindsley M. Reagents, stains, and media: Mycology. In: Carroll KC, Pfaller MA, Pritt BS, et al. Manual of Clinical Microbiology. 13th ed. ASM Press; 2023)
    
        PDF Report
            
                
                
                    
                    Indicates whether the report includes an additional document with charts, images or other enriched information
                
            
    
    
    
        Day(s) Performed
            
                
                
                    
                    Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
                
            
    
    Monday through Sunday
    
        Report Available
            
                
                
                    
                    The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        Fees :
            
                
                
                    
                    Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
                
            
    
    - Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
    
        Test Classification
            
                
                
                    
                    Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
                
            
    
    This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
    
        CPT Code Information
            
                
                
                    
                    Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
                
            
    
    CPT codes are provided by the performing laboratory.
87206
87176-Tissue processing (if appropriate)
    
        LOINC® Information
            
                
                
                    
                    Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
                
            
    
    | Test Id | Test Order Name | Order LOINC Value | 
|---|---|---|
| FS | Fungal Smear | 658-5 | 
| Result Id | Test Result Name | Result LOINC Value 
                                        
                                        Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
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|---|---|---|
| FS | Fungal Smear | 658-5 |