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Test Code CIMRP Coccidioides immitis/posadasii, Molecular Detection, PCR, Varies

Reporting Name

Coccidioides PCR

Useful For

Rapid detection of Coccidioides DNA, preferred method

 

An aid in diagnosing coccidioidomycosis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Additional Testing Requirements


This test should always be performed in conjunction with fungal culture; order FGEN / Fungal Culture, Routine.



Shipping Instructions


Specimen must arrive within 7 days of collection; specimen >7 days will be rejected.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction (PCR) requires the specimen to be processed in an environment in which contamination of the specimen by Coccidioides species DNA is unlikely.

 

Preferred Specimens: Body fluid, cerebrospinal fluid (CSF), ocular fluid, respiratory (eg, bronchoalveolar lavage [BAL], bronchial washing, sputum), fresh tissue, or bone

 

Acceptable Specimens: If no fresh specimen is available, digested respiratory specimens treated with N-acetyl-L-cysteine-sodium hydroxide (NALC/NaOH) are acceptable (eg, BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion)

 

Submit only 1 of the following specimens:

 

Specimen Type: Body fluid

Sources: Body, ocular, or CSF

Container/Tube: Sterile container

Specimen Volume: 1 mL

Additional Information: Only fresh, non-NALC/NaOH-digested body fluid is acceptable.

 

Specimen Type: Respiratory

Sources: BAL, bronchial washing, or sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL if only PCR ordered or 3 mL if PCR ordered with smear and culture

 

Specimen Type: Tissue

Sources: Fresh tissue or bone

Container/Tube: Sterile container

Specimen Volume: 5 to 10 mm

Collection Instructions: Keep moist with sterile water or sterile saline

Additional Information: Only fresh, non-NALC/NaOH-digested tissue is acceptable.

 

Acceptable

Specimen Type: NALC/NaOH-digested respiratory specimens

Sources: BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions:

1. Submit digested specimen treated with NALC/NaOH.

2. Clearly indicate on container and order form that specimen is a digested specimen.


Specimen Minimum Volume

Body fluid or nondigested respiratory specimen: 0.5 mL; Fresh tissue or bone: 5 mm; NALC-NaOH-digested specimen: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reference Values

Not applicable

Day(s) Performed

Monday through Sunday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798

Clinical Information

Coccidioidomycosis is caused by the dimorphic fungi, Coccidioides immitis and Coccidioides posadasii. These organisms are endemic to the southwestern regions of the United States, northern Mexico, and areas of Central and South America, with recent literature suggests the geographic area of endemicity may be expanding over time.

 

The gold standard for the diagnosis of coccidioidomycosis is culture of the organism from clinical specimens due to its high sensitivity. However, growth in culture may take up to several weeks, which can delay diagnosis and treatment. In addition, the propagation of Coccidioides species in the clinical laboratory is a significant safety hazard to laboratory personnel.

 

This polymerase chain reaction method can identify Coccidioides species directly from clinical specimens, allowing for a rapid diagnosis. Fungal culture should also always be performed since it may enhance detection, and the isolate may be needed for antifungal susceptibility testing.

Report Available

1 to 3 days

Reject Due To

Blood
Bone marrow
Specimen in anaerobe vial or viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth)
Feces
Swabs
Tissues in formalin fluid
Urine
Reject

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Disease States

  • Coccidioidomycosis

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.