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Category: Clinical Microbiology
General Approaches for Direct Detection and Identification of Fungi*, Page 1 of 2
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This chapter summarizes general approaches to the direct detection and identification of fungi in clinical samples. Techniques such as direct microscopy, histopathology, antigen and antibody detection, mass spectrometry, and nucleic acid detection are reviewed. The availability of commercial kits and the sensitivity and specificity of the various methods are detailed. Applications and limitations for each area are reviewed.
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(Row 1, left) Gram stain of BAL specimen showing Gram-negative branching septate hyphae of Aspergillus fumigatus. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f1
(Row 1, left) Gram stain of BAL specimen showing Gram-negative branching septate hyphae of Aspergillus fumigatus. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f1
(Row 1, right) Gram stain of skin biopsy with Gram-variable branching hyphae of Exophiala jeanselmei. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f2
(Row 1, right) Gram stain of skin biopsy with Gram-variable branching hyphae of Exophiala jeanselmei. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f2
(Row 2, left) Gram stain of skin biopsy with Gram-negative aseptate hyphae of the Rhizopus microsporus group. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f3
(Row 2, left) Gram stain of skin biopsy with Gram-negative aseptate hyphae of the Rhizopus microsporus group. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f3
(Row 2, right) Gram stain of sputum with Candida albicans showing Gram-positive budding yeast cells with pseudohyphae. doi:10.1128/9781555817381.ch116.f4
(Row 2, right) Gram stain of sputum with Candida albicans showing Gram-positive budding yeast cells with pseudohyphae. doi:10.1128/9781555817381.ch116.f4
(Row 3, left) Gram stain of spleen demonstrating ghost-like budding yeastlike cells with pseudohyphae. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f5
(Row 3, left) Gram stain of spleen demonstrating ghost-like budding yeastlike cells with pseudohyphae. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f5
(Row 3, right) Gram stain of vaginal secretions with Gram-positive budding yeast cells of Candida glabrata. doi:10.1128/9781555817381.ch116.f6
(Row 3, right) Gram stain of vaginal secretions with Gram-positive budding yeast cells of Candida glabrata. doi:10.1128/9781555817381.ch116.f6
(Row 4, left) Gram stain of skin abscess with Cryptococcus neoformans showing Gram-positive and Gram-variable budding yeast cells of variable size surrounded by amorphous orange halos. doi:10.1128/9781555817381.ch116.f7
(Row 4, left) Gram stain of skin abscess with Cryptococcus neoformans showing Gram-positive and Gram-variable budding yeast cells of variable size surrounded by amorphous orange halos. doi:10.1128/9781555817381.ch116.f7
(Row 4, right) Parker ink stain of skin lesion showing typical yeast cells and short, stubby hyphae of Malassezia spp. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f8
(Row 4, right) Parker ink stain of skin lesion showing typical yeast cells and short, stubby hyphae of Malassezia spp. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f8
(Row 1, left) Gomori methenamine silver (GMS) stain of BAL specimen showing Aspergillus fumigatus dichotomously branching septate hyphae. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f9
(Row 1, left) Gomori methenamine silver (GMS) stain of BAL specimen showing Aspergillus fumigatus dichotomously branching septate hyphae. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f9
(Row 1, right) Calcofluor white stain of BAL specimen showing Aspergillus fumigatus dichotomously branching septate hyphae. Magnification, approximately ×500. doi:10.1128/9781555817381.ch116.f10
(Row 1, right) Calcofluor white stain of BAL specimen showing Aspergillus fumigatus dichotomously branching septate hyphae. Magnification, approximately ×500. doi:10.1128/9781555817381.ch116.f10
(Row 2, left) GMS stain of skin biopsy with Rhizopus spp. showing ribbonlike hyphae. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f11
(Row 2, left) GMS stain of skin biopsy with Rhizopus spp. showing ribbonlike hyphae. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f11
(Row 2, right) Calcofluor white stain of Rhizopus spp. showing ribbonlike hyphae. Magnification, approximately ×500. doi:10.1128/9781555817381.ch116.f12
(Row 2, right) Calcofluor white stain of Rhizopus spp. showing ribbonlike hyphae. Magnification, approximately ×500. doi:10.1128/9781555817381.ch116.f12
(Row 3, left) GMS stain of lung biopsy specimen showing Aspergillus fumigatus with bulb formation at hyphal tip. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f13
(Row 3, left) GMS stain of lung biopsy specimen showing Aspergillus fumigatus with bulb formation at hyphal tip. Magnification, approximately ×1,000. doi:10.1128/9781555817381.ch116.f13
(Row 3, right) H&E stain of lung biopsy specimen showing Aspergillus fumigatus dichotomously branching septate hyphae (shown at arrow). Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f14
(Row 3, right) H&E stain of lung biopsy specimen showing Aspergillus fumigatus dichotomously branching septate hyphae (shown at arrow). Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f14
(Row 1, left) Diff-Quik stain of CSF with Cryptococcus neoformans. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f15
(Row 1, left) Diff-Quik stain of CSF with Cryptococcus neoformans. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f15
(Row 1, right) India ink preparation of CSF showing encapsulated budding yeast cell of Cryptococcus neoformans. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f16
(Row 1, right) India ink preparation of CSF showing encapsulated budding yeast cell of Cryptococcus neoformans. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f16
(Row 2, left) H&E stain of eumycotic mycetoma granule of Scedosporium apiospermum. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f17
(Row 2, left) H&E stain of eumycotic mycetoma granule of Scedosporium apiospermum. Magnification, approximately ×400. doi:10.1128/9781555817381.ch116.f17
(Row 2, right) Toluidine blue stain of BAL specimen showing cysts of P. jirovecii. doi:10.1128/9781555817381.ch116.f18
(Row 2, right) Toluidine blue stain of BAL specimen showing cysts of P. jirovecii. doi:10.1128/9781555817381.ch116.f18
(Row 3, left) Calcofluor white stain of toenail specimen showing arthroconidia and hyphae of Trichophyton rubrum. Magnification, approximately ×200. doi:10.1128/9781555817381.ch116.f19
(Row 3, left) Calcofluor white stain of toenail specimen showing arthroconidia and hyphae of Trichophyton rubrum. Magnification, approximately ×200. doi:10.1128/9781555817381.ch116.f19
(Row 3, right) Muriform (sclerotic) cells (copper penny) in tissue of Fonsecaea pedrosoi chromoblastomycosis. Magnification, ×1,000. doi:10.1128/9781555817381.ch116.f20
(Row 3, right) Muriform (sclerotic) cells (copper penny) in tissue of Fonsecaea pedrosoi chromoblastomycosis. Magnification, ×1,000. doi:10.1128/9781555817381.ch116.f20
(Row 1, left) GMS stain of lymph node showing characteristic cigar-shaped yeast cells of Sporothrix schenckii. doi:10.1128/9781555817381.ch116.f21
(Row 1, left) GMS stain of lymph node showing characteristic cigar-shaped yeast cells of Sporothrix schenckii. doi:10.1128/9781555817381.ch116.f21
(Row 1, right) Gram stain of abscess material showing large, broad-based, budding yeast cell with thick refractile wall characteristic of Blastomyces dermatitidis. doi:10.1128/9781555817381.ch116.f22
(Row 1, right) Gram stain of abscess material showing large, broad-based, budding yeast cell with thick refractile wall characteristic of Blastomyces dermatitidis. doi:10.1128/9781555817381.ch116.f22
(Row 2, left) GMS stain of lymph node showing blastoconidia of H. capsulatum. Magnification, ×625. doi:10.1128/9781555817381.ch116.f23
(Row 2, left) GMS stain of lymph node showing blastoconidia of H. capsulatum. Magnification, ×625. doi:10.1128/9781555817381.ch116.f23
(Row 2, right) H&E stain of Coccidioides immitis. Large, round, thick-walled spherules (10 to 80 µm in diameter) filled with endospores (2 to 5 µm in diameter). Young spherules have a clear center with peripheral cytoplasm and a prominent thick wall. doi:10.1128/9781555817381.ch116.f24
(Row 2, right) H&E stain of Coccidioides immitis. Large, round, thick-walled spherules (10 to 80 µm in diameter) filled with endospores (2 to 5 µm in diameter). Young spherules have a clear center with peripheral cytoplasm and a prominent thick wall. doi:10.1128/9781555817381.ch116.f24
(Row 3, left) Bright-field photomicrograph of Paracoccidioides brasiliensis showing multiple budding yeast cells resembling mariner’s wheels. Magnification, ×1,590. doi:10.1128/9781555817381.ch116.f25
(Row 3, left) Bright-field photomicrograph of Paracoccidioides brasiliensis showing multiple budding yeast cells resembling mariner’s wheels. Magnification, ×1,590. doi:10.1128/9781555817381.ch116.f25
(Row 3, right) Wright-Giemsa stain of BAL specimen showing characteristic fission yeast cells of Talaromyces marneffei. doi:10.1128/9781555817381.ch116.f26
(Row 3, right) Wright-Giemsa stain of BAL specimen showing characteristic fission yeast cells of Talaromyces marneffei. doi:10.1128/9781555817381.ch116.f26
Characteristic fungal morphology seen by direct examination of clinical specimens
Characteristic fungal morphology seen by direct examination of clinical specimens
Methods and stains available for direct microscopic and histological detection of fungi in clinical specimens
Methods and stains available for direct microscopic and histological detection of fungi in clinical specimens