Fungal Blood Culture




Test Mnemonic

HISTCL

CPT Codes

  • 87103 - QTY (1)
  • 87015 - QTY (1)

LOINC ®

11475-1

Aliases

  • Culture, Fungus Blood
  • Histoplasma Blood Culture

Performing Laboratory

Cleveland Clinic Laboratories


Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
4 mLBone marrowSodium or Lithium heparinized syringe AmbientA minimum of 1 mL of bone marrow should be drawn into a heparinized syringe. The recommended volume is 4 mL.
10 mLBloodIsolator 10 microbial tube AmbientFor adults, the specimen volume is 10 mL inoculated into the Isolator tube. For pediatric patients, the specimen volume is 1 - 10 mL, depending on the weight of the patient.

Minimum Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
5 mL    For blood specimens
1 mL    For bone marrow specimens

Stability

Environmental Condition Description
Ambient24 hours
RefrigeratedUnacceptable
FrozenUnacceptable

Days Performed

Sun - Sat

Turnaround Time

5 weeks

Methodology

Name Description
Culture 

Reference Range

Fungal Blood Culture
Sex Age From Age To Type Range Range Unit
       FreetextNo fungal growth 

Special Info

Number of Blood Cultures: Each general blood culture request will generate two sets of separately drawn blood cultures. The second blood culture can be drawn immediately after the first is drawn, provided the two blood cultures are collected separately (i.e., from different sites/arms). If the same arm must be used, collect the second culture 30 minutes after the first. A maximum of 4 blood culture sets is permitted in a 24-hour period. The alternate specimen type is a bone marrow. Ordering/Drawing a Fungal Blood Culture: Order a Fungal Blood Culture (HISTCL) to rule out Histoplasma. For blood specimens, an Isolator tube should be drawn; 10 mL optimal, 5 mL minimum. For bone marrow specimens, use a sodium or lithium heparinized syringe to draw the specimen; 4 mL optimal, 1 mL minimum. Patient Skin Preparation for Blood Draw: Select vein, swab with ChloraPrep Sepp (2% chlorhexidine gluconate with 70% alcohol applicator). Saturate the applicator tip by gently pressing it against the skin, and apply the solution in a back-and-forth motion for 30 seconds, completely wetting the area. Allow the prepped area to dry completely. Do not repalpate the vein. If the venipuncture is unsuccessful, re-prep the vein as above. Venipuncture and Inoculation: Perform venipuncture using a sterile syringe (10 mL for adults, 1-10mL for children depending on weight of the patient). Wipe the rubber stopper of the Isolator tube with a new ChloraPrep. Saturate the applicator tip by gently pressing it against the stopper, and apply the solution in concentric circles, completely wetting the stopper; allow the prepped area to dry completely. Inoculate the blood into the Isolator tube; 10 mL is optimal, minimum volume 5 mL. Invert tube several times to ensure thorough mixture. Label the Isolator tube with the collect date and time, collection site, set #1 or set #2, initials of individual drawing the blood, patient’s name, and patient clinic number. Transport: Blood culture and bone marrow specimens should be transported promptly (preferably within 2 hrs) at room temperature to the lab along with the requisition. If culture is positive, identification will be performed at an additional charge. Identification CPT codes that may apply include: 87106, 87107, 87153. Antimicrobial susceptibilities are performed when indicated, and CPT code 87186 would apply.

Clinical Info

This test can be used to rule out fungemia. A single negative culture does not rule out the presence of fungal infection. Blood cultures should be drawn prior to the administration of antibiotics and before an expected rise in temperature. Drawing blood immediately after administration of antibiotics will reduce recovery of pathogens.