Histoplasma (Please notify laboratory if suspected)
| Detection of Histoplasma species (Histoplasmosis) | |
| Microbiology | |
| Mycology | |
| Fungal culture: ○ Blood ○ Tissue/biopsy ○ BAL ○ Any other specimen submitted for routine fungal culture Serology/Antigen detection: ○ Plasma, serum ○ BAL, CSF, other body fluids ○ Urine |
Other Information
○ Ensure laboratory is notified
○ For Histoplasma serology, see Fungal serology
○ For Histoplasma serology, see Fungal serology
Fungal culture:
○ Blood: SPS vacutainer tube
○ BAL or Tissue/biopsy: sterile container
Antigen detection
○ Serum: serum separator tube or red top tube (min volume 5mL)
○ Plasma: EDTA, heparin or sodium citrate tube (5mL)
○ BAL/other body fluids: sterile container (0.5mL)
○ CSF: sterile container (0.8 mL)
○ Urine: sterile container (0.5mL)
○ Blood: SPS vacutainer tube
○ BAL or Tissue/biopsy: sterile container
Antigen detection
○ Serum: serum separator tube or red top tube (min volume 5mL)
○ Plasma: EDTA, heparin or sodium citrate tube (5mL)
○ BAL/other body fluids: sterile container (0.5mL)
○ CSF: sterile container (0.8 mL)
○ Urine: sterile container (0.5mL)
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:
Decontaminate skin, collect at least 1mL of CSF by lumbar puncture into a sterile container, collect more CSF if additional cultures are requested. If more than one tube can be successfully collected, the microbiology laboratory should receive the second or third tube (whicheve is less bloody) to avoid contamination by skin flora or blood.
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:
Decontaminate skin, collect at least 1mL of CSF by lumbar puncture into a sterile container, collect more CSF if additional cultures are requested. If more than one tube can be successfully collected, the microbiology laboratory should receive the second or third tube (whicheve is less bloody) to avoid contamination by skin flora or blood.
Refer to section Sample Processing / Delivery
Fungal Culture - in-house Quantitative Antigen EIA
MIRAVISTA
MIRAVISTA
○ Culture/confirmation: Up to 21 days
○ Antigen detection: Up to 3 days after receipt of specimen
○ Antigen detection: Up to 3 days after receipt of specimen
416-586-4800 extension 4432
YES; notify the laboratory if this agent is suspected
○ Blood, CSF and skin should be stored at room temp (20-25˚C) after collection and submitted to the UHN/SH Microbiology Lab ASAP. Other specimens should be stored at refrigeration temp if a delay of more than 2h is expected.
○ The specimen will be referred to the PHOL for testing if there is fungal growth suggestive of Histoplasma species OR for serology testing.
○ The specimen will be referred to MiraVista Diagnostics for antigen detection.
○ The specimen will be referred to the PHOL for testing if there is fungal growth suggestive of Histoplasma species OR for serology testing.
○ The specimen will be referred to MiraVista Diagnostics for antigen detection.