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Test ID: HBRP Histoplasma capsulatum/Blastomyces species, Molecular Detection, PCR, Varies

Reporting Name

Histoplasma/Blastomyces PCR

Useful For

Rapid detection of Histoplasma capsulatum and Blastomyces dermatitidis DNA

 

Aiding in the rapid diagnosis of histoplasmosis and blastomycosis

Clinical Information

Infections with Blastomyces dermatitidis and Histoplasma capsulatum cause a variety of clinical manifestations ranging from self-limited, mild pulmonary illness to potentially life-threatening, disseminated disease. Primary infections are acquired through inhalation of conidia that are present in the environment. In the United States, most cases of blastomycosis and histoplasmosis occur along the Ohio and Mississippi River valleys, although recent studies suggest the geographic area of endemicity may be expanding.

 

The gold standard for diagnosis of blastomycosis and histoplasmosis remains isolation of the organisms in culture. Although sensitive, recovery in culture and subsequent identification may require days to weeks. This polymerase chain reaction assay can provide rapid and specific detection and differentiation of B dermatitidis/gilchristii and H capsulatum directly from clinical specimens.

Interpretation

A positive result for Histoplasma capsulatum indicates presence of Histoplasma DNA; a positive result for Blastomyces dermatitidis/gilchristii indicates presence of Blastomyces DNA.

 

A negative result indicates absence of detectable H capsulatum and B dermatitidis/gilchristii DNA. Fungal culture has increased sensitivity over this polymerase chain reaction (PCR) assay and should always be performed when the PCR is negative.

Report Available

1 to 3 days

Day(s) Performed

Monday through Sunday

Clinical Reference

1.Wheat LJ, Azar MM, Bahr NC, Spec A, Relich RF, Hage C: Histoplasmosis. Infect Dis Clin North Am. 2016 Mar;30(1):207-227. doi: 10.1016/j.idc.2015.10.009

2.Azar MM, Loyd JL, Relich RF, Wheat LJ, Hage CA: Current concepts in the epidemiology, diagnosis, and management of Histoplasmosis syndromes. Semin Respir Crit Care Med. 2020 Feb;41(1):13-30. doi: 10.1055/s-0039-1698429

3.Linder KA, Kauffman CA, Miceli MH: Blastomycosis: A review of mycological and clinical aspects. J Fungi (Basel). 2023 Jan 14;9(1):117. doi: 10.3390/jof9010117

4.Smith DJ, Williams SL; Endemic Mycoses State Partners Group; Benedict KM, Jackson BR, Toda M: Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis - United States, 2019. MMWR Surveill Summ. 2022 Aug 19;71(7):1-14. doi: 10.15585/mmwr.ss7107a1

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Specimen Type

Varies


Ordering Guidance


Urine is not an acceptable source for this assay. Studies indicate that Histoplasma DNA is not routinely found in the urine of patients with disseminated histoplasmosis. The recommended test for urine specimens is HSTQU / Histoplasma Antigen, Quantitative Enzyme Immunoassay, Random, Urine.



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; specimens received after 7 days will be rejected.

 

N-acetyl-l-cysteine-sodium hydroxide (NALC/NaOH)-digested specimen must arrive within 7 days of digestion.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Histoplasma or Blastomyces species DNA is not likely.

 

Submit only 1 of the following specimens:

 

Specimen Type: Body fluid

Sources: Body, spinal fluid, bone marrow

Container/Tube: Sterile container

Specimen Volume: 1 mL

 

Specimen Type: Respiratory

Sources:  Bronchoalveolar lavage, bronchial washing, sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL

 

Specimen Type: Tissue or bone

Container/Tube: Sterile container

Specimen Volume: 5-10 mm

Collection Instructions: Collect a fresh tissue or bone specimen.

 

Acceptable:

Specimen Type: N-acetyl-l-cysteine-sodium hydroxide (NALC/NaOH)-digested respiratory specimens

Sources: Lavage fluid, bronchial washing, gastric 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 respiratory specimen: 0.5 mL

Specimen Stability Information

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

Reference Values

Not applicable

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 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HBRP Histoplasma/Blastomyces PCR 81653-8

 

Result ID Test Result Name Result LOINC Value
SRC78 Histo/Blasto Source 31208-2
32457 Histo/Blasto Result 81653-8

Testing Algorithm

For more information see Meningitis/Encephalitis Panel Algorithm

Forms

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

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information:

mml-immunocompromised, mml-mbid-cnsinfections, mml-respiratoryinfections