Specimens are cultured on selective fungal media (eg.,inhibitory mold agar and brain heart infusion blood agar with chloramphenicol and gentamicin). Respiratory sources also are cultured on brain heart infusion agar with chloramphenicol, gentamicin, and cycloheximide. Cultures are incubated for 24 days at 30 degrees C.
Identification of fungi is based on colonial and microscopic morphology, MALDI-TOF mass spectrometry, laboratory-developed real-time PCR assays and/or D2 rRNA gene sequencing, as applicable.(Babady NE, Buckwalter SP, Hall L: Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real-time PCR. J Clin Microbiol 2011;49:3204-3208; Binnicker MJ, Buckwalter SP, Eisberner JJ: Detection of Coccidioides species in clinical specimens by real-time PCR. J Clin Microbiol 2007;45:173-178; Dhiman N, Hall L, Wohlfiel SL: Performance and cost analysis of matrix-assisted laser desorption ionization time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol 2011;49:1614-1616; Hall L, Wohlfiel SL, Roberts GD: Experience with the MicroSeq D2 large-subunit ribosomal DNA sequencing kit for identification of filamentous fungi encountered in the clinical laboratory. J Clin Microbiol 2004;42:622-626; Theel ES, Schmidt BH, Hall L: Formic acid-based direct, on-plate testing of yeast and Corynebacterium species by Bruker Biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2012;50:3093-3095; Theel ES, Hall L Mandrekar J: Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2011;49:4067-4071)
24 days/Positive cultures reported when detected. Preliminary negative report generated at 7 and 14 days