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22650 Fungus, Direct Wet Prep

Fungus, Direct Wet Prep
Test Code: KOHFS
Synonyms/Keywords
KOH Smear, Calcofluor white smear, fungal, fungus
Useful For
​Presumptive diagnosis of fungal elements in direct specimens.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​
Any
(except blood and bone marrow)​
Sterile leakproof container ESwab, or other Amies medium based swab

 

1-10 mL
1-10 g
1-3 nails or skin scrapings

 

1 swab​
1 mL
1 g
1 nail
 
Skin scrapings

1 swab

1 mL
1 g
1 nail

 

Skin scrapings

 

1 swab

 

Collection Processing Instructions
A fungus wet prep is routinely performed on respiratory specimens and pleural fluids submitted on fungus culture.  Only order this test if a fungus wet prep is desired and:

- A non-respiratory specimen is also being submitted for fungus culture.
- A fungus culture is not being ordered.
 
Swabs:
- ESwab: collect one swab for Gram stain, aerobic and anaerobic cultures, and an additional swab for each additional culture type or stain (e.g. fungus or mycobacteria).
- Other Amies medium swab types: collect one swab for every culture and stain (including Gram) to be ordered.
 
 
Specimens should be collected in sterile leakproof containers without preservatives.  Swab-collected specimens and fecal specimens are NOT recommended. One swab in Amies or Stuarts transport medium may be submitted from urogenital or oral sources only. Moisten small pieces of tissue with several drops of sterile, non-bacteriostatic normal saline.
 
For nail and skin samples, see Culture, Fungus-Dermal (FSKIN).
 
For blood and bone marrow FUNG culture, see CULTURE, Fungus-Blood (FBLD).
Specimen Stability Information
Specimen Type Temperature Time
CSF​ Room Temperature​ <72 hours​
All other specimen types​ Room Temperature​ < = 4 hours
Refrigerate​ > 4 hours
Rejection Criteria
Dried swabs or tissues
Specimens submitted in formalin or other preservatives​
​Leaking specimens
​Specimens older than 4 days
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Bloomer​ ​Monday through Friday ​1 day​ Potassium Hydroxide/​Light Microscopy​
​Cadott ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Chetek ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Chippewa Falls ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Colby/Abbotsford ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Cornell ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Cumberland ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Diagnostic Treatment Center​ ​Monday through Sunday ​1 day Potassium Hydroxide/​Light Microscopy
Eagle River​ ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Eau Claire ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Flambeau Hospital ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Hayward ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Ladysmith Medical Center ​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Lake Hallie ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Lakeview Medical Center ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Marshfield Monday through Friday ​1 day KOH/Calcofluor Stain/Microscopy
Menomonie​ ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Merrill ​Monday through Saturday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Minocqua ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Mosinee ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Neillsville​Monday through Sunday​1 day​Potassium Hydroxide/​Light Microscopy
Oakwood​ ​Monday through Friday ​​1 day ​Potassium Hydroxide/​Light Microscopy
​Phillips ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Rhinelander ​Monday through Friday ​1 day ​Potassium Hydroxide/​Light Microscopy
​Stettin ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Stevens Point ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Wausau​ ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Wisconsin Rapids ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Wittenberg ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Test Information
Microscopic examinations are less sensitive than culture for fungi and do not yield information concerning the viability of observed organisms.
 
The fungal load in a clinical specimen may be low. Specimens with less than the recommended volumes may therefore lead to a false negative result.
‘ESwab’ is a trademark of Copan Diagnostics.
Reference Range Information
Performing Location Reference Range
All Performing Sites No fungal elements observed​
See Critical Value List for list of current critical values.​
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
87206​ Calcofluor​
87220​ KOH (Potassium Hydroxide)​
Synonyms/Keywords
KOH Smear, Calcofluor white smear, fungal, fungus
Ordering Applications
Ordering Application Description
​Centricity

​a. Stain Fungal Direct

b. KOH Fungal

​Cerner ​KOH Fungal Direct Exam
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​
Any
(except blood and bone marrow)​
Sterile leakproof container ESwab, or other Amies medium based swab

 

1-10 mL
1-10 g
1-3 nails or skin scrapings

 

1 swab​
1 mL
1 g
1 nail
 
Skin scrapings

1 swab

1 mL
1 g
1 nail

 

Skin scrapings

 

1 swab

 

Collection Processing
A fungus wet prep is routinely performed on respiratory specimens and pleural fluids submitted on fungus culture.  Only order this test if a fungus wet prep is desired and:

- A non-respiratory specimen is also being submitted for fungus culture.
- A fungus culture is not being ordered.
 
Swabs:
- ESwab: collect one swab for Gram stain, aerobic and anaerobic cultures, and an additional swab for each additional culture type or stain (e.g. fungus or mycobacteria).
- Other Amies medium swab types: collect one swab for every culture and stain (including Gram) to be ordered.
 
 
Specimens should be collected in sterile leakproof containers without preservatives.  Swab-collected specimens and fecal specimens are NOT recommended. One swab in Amies or Stuarts transport medium may be submitted from urogenital or oral sources only. Moisten small pieces of tissue with several drops of sterile, non-bacteriostatic normal saline.
 
For nail and skin samples, see Culture, Fungus-Dermal (FSKIN).
 
For blood and bone marrow FUNG culture, see CULTURE, Fungus-Blood (FBLD).
Specimen Stability Information
Specimen Type Temperature Time
CSF​ Room Temperature​ <72 hours​
All other specimen types​ Room Temperature​ < = 4 hours
Refrigerate​ > 4 hours
Rejection Criteria
Dried swabs or tissues
Specimens submitted in formalin or other preservatives​
​Leaking specimens
​Specimens older than 4 days
Useful For
​Presumptive diagnosis of fungal elements in direct specimens.
Reference Range Information
Performing Location Reference Range
All Performing Sites No fungal elements observed​
See Critical Value List for list of current critical values.​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Bloomer​ ​Monday through Friday ​1 day​ Potassium Hydroxide/​Light Microscopy​
​Cadott ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Chetek ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Chippewa Falls ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Colby/Abbotsford ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Cornell ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Cumberland ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Diagnostic Treatment Center​ ​Monday through Sunday ​1 day Potassium Hydroxide/​Light Microscopy
Eagle River​ ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Eau Claire ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Flambeau Hospital ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Hayward ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Ladysmith Medical Center ​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Lake Hallie ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Lakeview Medical Center ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Marshfield Monday through Friday ​1 day KOH/Calcofluor Stain/Microscopy
Menomonie​ ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Merrill ​Monday through Saturday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Minocqua ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Mosinee ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Neillsville​Monday through Sunday​1 day​Potassium Hydroxide/​Light Microscopy
Oakwood​ ​Monday through Friday ​​1 day ​Potassium Hydroxide/​Light Microscopy
​Phillips ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Rhinelander ​Monday through Friday ​1 day ​Potassium Hydroxide/​Light Microscopy
​Stettin ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Stevens Point ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
Wausau​ ​​Monday through Sunday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Wisconsin Rapids ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
​Wittenberg ​Monday through Friday ​1 day​ ​Potassium Hydroxide/​Light Microscopy
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
87206​ Calcofluor​
87220​ KOH (Potassium Hydroxide)​
For most current information refer to the Marshfield Laboratory online reference manual.