Fungal Culture

(Microbiology)

The following guidance applies to collection & transport of samples for superficial fungal investigation, that being skin, nail and hair fungal infections. For systemic or non-superficial mycoses, consult laboratory handbook for advice on collection of specimen type being sampled. Indicate on request form that fungal investigation is required. Please note that moisture can inhibit fungal growth, therefore for tissue and biopsy specimens it is preferential to send a second tissue sample without saline marked for fungal investigation. For all fungal investigations, in particular systemic mycoses, ensure clinical information is stated including animal contact, environmental exposure and travel abroad (including periods of domicile other than UK).

Investigations	Fungal culture Fungal microscopy (including tinea/pityriasis versicolor)
Inform lab before sending	No
Specimen type	Skin Nail Hair
Ideal time to take specimen	Before commencing treatment
Specimen container	Skin, nail and hair: Fungal transport packet e.g. Mycotrans, Dermapak If unavailable specimen is collected into paper - preferably dark coloured - which is folded, secured and placed in a sterile leak-proof container or sealed plastic bag. Swabs: Blue capped containing Stuarts transport media
Labelling requirements	click here
How to take the specimen	Before sampling clean area of any treatment creams. Ensure samples are dry. Skin: scrape with blunt scalpel blade, sample advancing edges of lesion as they yield most viable fungus. Nail: cut with chiropody scissors as far back from nail tip as possible, as viable fungi is more likely found in the most proximal part of diseased nail. Sample the full thickness of nail and include any debris or crumbly material under the diseased nail. Nail drills, scalpels and nail elevators may be helpful but must be sterilised between patients. For superficial nail infection scrape the affected nail plate with a curette or blunt scalpel blade. Hair: this should include both scalp scrapings and plucked hairs. Scalp scrapings contain hair stumps, increasing chance of isolation as fungal hair infection often infects areas close to the scalp surface. For sampling scalp scrape affected area with blunt scalpel blade.
Volume:	Plentiful and representative
Transport to the laboratory	If transport is delayed then store at room temperature
Turnround	Microsopy: Interim report at 48 - 96 hours Culture:- 4-6 weeks
Additional information	Quality of specimen type Swabs: little value for dermatophytes and should be used when insufficient material is obtained by scraping. Hair: cut hair is not a quality sample. Nail: specify on request form whether fingernail or toenail. Skin: specify on request form if pityriasis versicolor is suspected. For further information consult: HPA, 2009, Fungal Skin & Nail Infections: Diagnosis & Laboratory Investigation Quick Reference Guide for Primary Care [Internet] Available click here
Specimen retention	4 weeks - please make any requests for additional tests within 7 days of request

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