Detection and identification of fungal organisms in CSF
Microbiology
Mycology
○ CSF (minimum 1 mL, the larger the volume, the better the yield)
Other Information
○ Swabs are not acceptable specimens for fungal culture ○ Many fungal species are slow growing and require prolonged periods of incubation. PCR would not be performed unless fungal elements were seen on primary stain but an organism failed to grow in culture
○ Please notify the laboratory if a dimorphic fungi is suspected (indicate on the requisition and/or phone the laboratory)
○ Sterile container
○CSF by lumbar puncture: Decontaminate skin, collect at least 1 mL of CSF by lumbar puncture into a sterile container; 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. ○CSF by shunt/drain/Ommaya reservoir: Clean reservoir site with antiseptic solution and alcohol prior to removing fluid. Collect CSF from drain/shunt attached to intracranial device into sterile container. If device is an Ommaya reservoir, aspirate CSF using a sterile needle and syringe; label accordingly (e.g. CSF from shunt or Ommaya reservoir as opposed to simply “CSF”)
Refer to section Sample Processing / Delivery
In-house
○ Up to 28 days
416-586-4800 extension 4496
○ NO; but laboratory should be notified if dimorphic fungal organism suspected
○ Label specimen container and outer biohazard specimen bag with printed electronic laboratory order sticker. Place specimens in biohazard bag, seal
○ Specimens can be held at room temperature (20-25˚C) after collection and transported to the UHN/SH Microbiology Laboratory ASAP after collection. Specimens should be stored at room temperature after collection if a delay is anticipated.