Diagnosis and treatment of the etiologic agents of fungemia
Select patient population that presents with signs and symptoms of sepsis, especially fever of unknown origin
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
D2F | D2 Fungal Sequencing Identification | No, (Bill Only) | No |
FUNA | Fungal Ident Panel A | No, (Bill Only) | No |
FUNB | Fungal Ident Panel B | No, (Bill Only) | No |
LCCI | Ident Rapid PCR Coccidioides | No, (Bill Only) | No |
LCHB | Id, Histoplasma/Blastomyces PCR | No, (Bill Only) | No |
RMALF | Id MALDI-TOF Mass Spec Fungi | No, (Bill Only) | No |
RMALY | Id MALDI-TOF Mass Spec Yeast | No, (Bill Only) | No |
LCCA | Id, Candida auris Rapid PCR | No, (Bill Only) | No |
When this test is ordered, reflex testing may be performed at an additional charge.
Conventional Broth Culture/Macroscopic/Microscopic/Nucleic Acid Hybridization/D2 rDNA Gene Sequencing/Real-Time Polymerase Chain Reaction (rtPCR)/Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)
Dimorphic Pathogen Identification Confirmation: Nucleic Acid Hybridization/D2 rDNA Gene Sequencing/rtPCR/MALDI-TOF MS
Culture, Fungus
Culture, Yeast
Fungus Culture
Mold
Mycology Culture
Yeast Culture
50022-FBL
When this test is ordered, reflex testing may be performed at an additional charge.
Whole blood
Question ID | Description | Answers |
---|---|---|
Q00M0019 | Specimen Source |
Container/Tube:
Preferred: Green top (heparin)
Acceptable: SPS/Isolator tube
Specimen Volume: 10 to 30 mL
Collection Instructions:
1. Send specimen in original tube. Do not aliquot.
2. If collecting in an Isolator tube, draw blood in tube, and send 8 mL of whole blood in the original Isolator tube.
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
5 mL
Pediatric: 1.5 mL
Blood culture bottles (eg, BACTEC MycoF Lytic) | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Ambient (preferred) | 7 days | |
Refrigerated | 7 days |
Diagnosis and treatment of the etiologic agents of fungemia
Select patient population that presents with signs and symptoms of sepsis, especially fever of unknown origin
When this test is ordered, reflex testing may be performed at an additional charge.
Due to the high mortality rate from fungemia, the expeditious
Negative
If positive, notification is made as soon as the positive culture is detected or identified.
Positive cultures of yeast and filamentous fungi are reported with the organism identification.
Positive cultures are usually an indication of infection and are reported as soon as detected. Correlation of culture results and the clinical situation is required for optimal patient management. A final negative report is issued after 30 days of incubation.
No significant cautionary statements
1. Reimer LG, Wilson ML, Weinstein MP: Update on detection of bacteremia and fungemia. Clin Microbiol Rev. 1997 Jul;10(3):444-465
2. Procop GW, Cockerill FR III, Vetter EA, Harmsen WS, Hughes JG, Roberts GD: Performance of five agar media for recovery of fungi from isolator blood cultures. J Clin Microbiol. 2000 Oct;38(10):3827-3829
3. Procop GW, Church DL, Hall GS, et al: Mycology. In: Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 7th ed. Walters Kluwer; 2017:1322-1416
Blood is inoculated into MycoF Lytic (Becton Dickinson) and Isolator (Wampole) tubes. Continuously monitored blood culture instruments provide for the detection of bloodstream infections due to most Candida species and Cryptococcus species. The Isolator tube contains saponin to lyse the blood cells, enabling the release of intracellular organisms. Centrifugation generates a concentrated layer of organisms that is inoculated onto solid media for recovery of fungi and this appears to be the most sensitive method for recovery of Histoplasma capsulatum, other dimorphic fungi, and filamentous fungi.(Sutton DA: Specimen collection, transport, and processing: Mycology. In: Murray PR, Baron EJ, Jorgensen JH, et al. Manual of Clinical Microbiology. 9th ed. ASM Press; 2007:1728-1736)
Identification of fungi is based on colonial and microscopic morphology, matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry, nucleic acid hybridization probes, laboratory-developed real-time polymerase chain reaction assays and/or D2 rDNA gene sequencing, as applicable.(Babady NE, Buckwalter SP, Hall L, Le Febre KM, Binnicker MJ, Wengenack NL: Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real-time PCR. J Clin Microbiol. 2011 Sep;49[9]:3204-3208; Binnicker MJ, Buckwalter SP, Eisberner JJ, et al: Detection of Coccidioides species in clinical specimens by real-time PCR. J Clin Microbiol. 2007 Jan;45[1]:173-178; Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL: Performance and cost analysis of matrix-assisted laser desorption ionization time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol. 2011 Apr:49[4];1614-1616; Hall L, Wohlfiel SL, Roberts GD: Experience with the MicroSeq D2 large-subunit ribosomal DNA sequencing kit for identification of filamentous fungi encountered in the clinical laboratory. J Clin Microbiol. 2004 Feb;42[2]:622-626; Theel ES, Schmidt BH, Hall L, et al: Formic acid-based direct, on-plate testing of yeast and Corynebacterium species by Bruker Biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2012 Sep;50[9]:3093-3095; Theel ES, Hall L, Mandrekar J, Wengenack NL: Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2011 Dec;49[12]:4067-4071)
Monday through Sunday
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.
87015-Concentration (any type) for infectious agents
87103-Blood
87106-Id MALDI-TOF Mass Spec Yeast (if appropriate)
87107-Id MALDI-TOF Mass Spec Fungi (if appropriate)
87107-Fungal identification panel A (if appropriate)
87107-Fungal identification panel B (if appropriate)
87150-Identification rapid PCR coccidioides (if appropriate)
87150 x 2- Identification Histoplasma/Blastomyces, PCR (if appropriate)
87153-D2 fungal sequencing identification (if appropriate)
87150- Id, Candida auris Rapid PCR (if appropriate)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
FBL | Fungal Culture, Blood | 601-5 |
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.
|
---|---|---|
FBL | Fungal Culture, Blood | 601-5 |
Change Type | Effective Date |
---|---|
Test Status - Test Resumed | 2021-12-08 |
Test Status - Test Down | 2021-10-14 |