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22871 Silver Stain for Pneumocystis and Fungi

Silver Stain for Pneumocystis and Fungi
Test Code: SILVER
Synonyms/Keywords
​Stain for PCP, PCP, Pneumocystis pneumonia, fungus, fungal
Useful For
​The microscopic detection of Pneumocystis jirovecii and other fungi in lower respiratory tract secretions and fluids using the Methenamine Silver stain.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Lower respiratory secretions, lavage or pleural fluid​ Sage container, LUKI tube and other similar sterile aspiration devices/traps​ Any other sterile screw-cap container​ 1 mL​ 0.5 mL​ 0.25 mL​
Collection Processing Instructions

May be performed on unfixed lower respiratory secretions and fluids for the detection of Pneumocystis jirovecii and other fungi such as Blastomyces dermatitidis.

Specimens fixed for cytopathological studies may be examined by Methenamine Silver staining: see CYTOLOGY, BRONCHIAL WASHINGS FOR FUNGUS STAIN or CYTOLOGY, SPUTUM FOR FUNGUS STAIN.

Tissues should be submitted to the Histology lab for fixation and Methenamine Silver staining: see SURGICAL PATHOLOGY, SPECIAL STAINS, GROUP 1.

Specimen Stability Information
Specimen Type Temperature Time
​All Room Temperature​ <2 hours​
All​ 2-8 C​ 2-72 hours​
If cultures also ordered,  follow handling instructions for those cultures if different​
Rejection Criteria
Preserved specimens - consult with Cytology as to suitability of the preservative
Frozen specimens​
Swab specimens​
>72 hours old​
Interference
​Grossly mucinous specimens will be processed, but sensitivity of the assay will be reduced due to high background staining.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield Monday through Friday​ 4-6 hours​ Manual staining, light microscopy​
Test Information
Expectorated sputum and endotracheal aspirates, while acceptable for examination by this method, have inferior sensitivity for Pneumocystis jirovecii compared to bronchial specimens and lung tissue.
 
Microscopic reading and interpretation is performed by a doctoral level microbiologist.
Reference Range Information
Performing Location Reference Range
​Marshfield Negative for Pneumocystis jirovecii and other fungi​
​ See Critical Value List for list of current critical values.​
Interpretation
​Any amount of Pneumocystis jirovecii, Coccidioides immitis spherules, fungal hyphal elements, or of yeast cells consistent with Blastomyces dermatitidis or Histoplasma capsulatum should be considered an abnormal finding. (Such findings will always be denoted by an interpretative comment.) However, small to moderate amounts of yeasts, with or without attendant hyphal elements, that are consistent with Candida species may indicate colonization and/or contamination with oral flora during the collection process.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88312​ ​ ​ ​Special stain ​
Synonyms/Keywords
​Stain for PCP, PCP, Pneumocystis pneumonia, fungus, fungal
Ordering Applications
Ordering Application Description
​Centricity ​Stain Silver
​Cerner ​Silver Stain
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Lower respiratory secretions, lavage or pleural fluid​ Sage container, LUKI tube and other similar sterile aspiration devices/traps​ Any other sterile screw-cap container​ 1 mL​ 0.5 mL​ 0.25 mL​
Collection Processing

May be performed on unfixed lower respiratory secretions and fluids for the detection of Pneumocystis jirovecii and other fungi such as Blastomyces dermatitidis.

Specimens fixed for cytopathological studies may be examined by Methenamine Silver staining: see CYTOLOGY, BRONCHIAL WASHINGS FOR FUNGUS STAIN or CYTOLOGY, SPUTUM FOR FUNGUS STAIN.

Tissues should be submitted to the Histology lab for fixation and Methenamine Silver staining: see SURGICAL PATHOLOGY, SPECIAL STAINS, GROUP 1.

Specimen Stability Information
Specimen Type Temperature Time
​All Room Temperature​ <2 hours​
All​ 2-8 C​ 2-72 hours​
If cultures also ordered,  follow handling instructions for those cultures if different​
Rejection Criteria
Preserved specimens - consult with Cytology as to suitability of the preservative
Frozen specimens​
Swab specimens​
>72 hours old​
Interference
​Grossly mucinous specimens will be processed, but sensitivity of the assay will be reduced due to high background staining.
Useful For
​The microscopic detection of Pneumocystis jirovecii and other fungi in lower respiratory tract secretions and fluids using the Methenamine Silver stain.
Reference Range Information
Performing Location Reference Range
​Marshfield Negative for Pneumocystis jirovecii and other fungi​
​ See Critical Value List for list of current critical values.​
Interpretation
​Any amount of Pneumocystis jirovecii, Coccidioides immitis spherules, fungal hyphal elements, or of yeast cells consistent with Blastomyces dermatitidis or Histoplasma capsulatum should be considered an abnormal finding. (Such findings will always be denoted by an interpretative comment.) However, small to moderate amounts of yeasts, with or without attendant hyphal elements, that are consistent with Candida species may indicate colonization and/or contamination with oral flora during the collection process.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield Monday through Friday​ 4-6 hours​ Manual staining, light microscopy​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
88312​ ​ ​ ​Special stain ​
For most current information refer to the Marshfield Laboratory online reference manual.