Fungal culture:
Blood
○ Collect 8 mL of blood into a clean, sterile syringe with aseptic technique. Transfer the blood into an SPS tube. Transport to the laboratory immediately for processing.
Tissue/biopsy
○ Collect 5-10 mm3 tissue aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline.
BAL
○ Pass bronchoscope transnasally or transorally (if patient is not intubated) or via endotracheal tube (if patient is intubated). Instill a large volume of 0.85% sterile saline (nonbacteriostatic) into the airway lumen. Discard the initial fluid recovered (likely contaminated). Collect remaining fluid in a clean, sterile container via suction.
Antigen detection:
Whole blood/serum/plasma:
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood.
Urine:
○ Collect urine into a clean, sterile container. Transport to the microbiology laboratory ASAP.
CSF by lumbar puncture:
Decontaminate skin, collect at least 1mL of CSF by lumbar puncture into a sterile container; collect more CSF if additional cultures are requested (AFB, fungal, etc.). If more than one tube can be successfully collected, the microbiology laboratory should receive the second or third tubes (whichever is less bloody) to avoid contamination by skin flora or blood.