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Fungi test

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How fungi test is used?

The fungi test is used to help detect and diagnose a fungal infection, guide treatment, and / or sometimes to monitor the effectiveness of treatment.

For many superficial skin infections caused by yeast, a clinical examination of the person concerned and microscopic examination of the sample may be sufficient to determine that a fungal infection is present.

The specific organism is not always identified. The doctor has several options, topical and oral, and the selection of the antifungal treatment is based on practice guidelines and experience.

For persistent, deeper or systemic infections, several tests can be used for diagnosis and monitoring:

      

Fungal cultures

They are used to identify specific fungi. Many fungi grow slow, making that test taking weeks to get the results. Sensitivity tests on fungi on isolated fungus from a culture are used to determine which antifungal  is best for treatment.

Fungal antigens and antibodies tests

They can be used to determine whether an individual has or recently had a specific fungal infection. They are faster than fungal cultures tests , but only serves to test a specific species of fungi, so the doctor has to know what fungal organism is present for testing.

Many people have fungal antibodies from a previous exposure to the organism so that an antibody test alone can not confirm the presence of an active infection.

Sometimes, blood samples are collected 2 to 3 weeks apart (acute and convalescent samples) and are performed to see if antibodies levels are changing and the evaluation of these results may take several weeks.

Molecular tests

They can be performed to identify fungi that grow in culture and sometimes can be used to detect a specific fungus directly into the sample collection.

How does fungi test used?

Potassium hydroxide solution

Samples of skin scrapings, hair or nails, tissues, vaginal smears, body fluids, sputum are used.

The sample is placed on a slide and the chemical solution dissolves no fungal elements; it reveals yeast cells and hyphae (filaments branching) of fungi on a microscope slide. It is performed by a doctor or a trained laboratory technician.

It is a test for fungi primary screening. It detects fungi, but does not provide specific information on the species.

White calcofluor

Samples of skin scrapings, hair or nail clippings, vaginal frotis, body fluids and sputum are used. Calcofluor joins the fungal elements in a sample and becomes fluorescent under ultraviolet light.

It allows viewing on a microscope slide. It is one of the most sensitive fungi display means. It detects fungi, but does not provide specific information on the type of fungus. It is a quick test for fungi.

Fungi cultivation

Samples of skin, nails, hair, body fluids, tissues, vaginal swabs, sputum, blood are used. Sample is placed in a nutrient medium and incubated standing for fungi to grow in the sample. It is a test for fungi that serves as the main tool to diagnose a fungal infection.

Growth of fungi can then perform identification tests and susceptibility testing. It takes weeks to obtain results.

When a more definitive diagnosis is needed, as in cases of persistent, deep or systemic infections  it may be necessary to carry out more extensive tests to identify which fungus is causing the infection and help determine treatment can be more effective.

This usually involves a combination of the above tests, plus the following tests:

Sensitivity tests

A sample of isolated fungi  in culture is used. Tracking of fungi cultivation is performed and when a fungal pathogen has been identified, susceptibility testing is performed to determine the most effective antifungal agent to be used. It is used as a guide for treatment and results are obtained days or weeks after culture.




Antigens test

A sample of blood, urine, cerebrospinal fluid, body fluid are used. It detects proteins associated with a specific fungus.

This type of test is available for a variety of fungi. It helps diagnose a specific fungus infection. It takes only days to complete. Some quick tests are available for some fungi (eg, Cryptococcus, Histoplasma species).

Antibodies determination

Its is made through blood tests and body fluids .It detects an immune response to a specific fungus. It can be performed in a single sample or in acute and convalescent samples collected 2 to 3 weeks apart. It diagnoses current or recent infection by specific fungus; oversees treatment. It may take days or weeks.

Molecular testing for DNA, RNA of sample isolated fungus in culture, blood, body fluids.

It detects the genetic material of a specific fungus. It can detect some fungi; however, it is not a widely available test, only found in some research environments. The results take days or weeks.

When fungi test should be ordered?

Fungi tests are requested each time the doctor suspects that the signs and symptoms of a person is due to a fungal infection. Many signs and symptoms of fungal infections are similar to those caused by bacteria and / or viruses, fungi tests are often ordered when it is unclear what is causing the disease.

In the case of surface infection, fungi tests can be ordered when symptoms on the skin, nails or mucous membranes appear. Some examples are:

  •  Red skin,  itchy areas, scaly skin
  •  Brittle and / or deformed  nails
  •  White patches in mouth (thrush)
  •  Vaginal itching and secretion (yeast infection)

Deep, systemic fungal infections can cause a variety of symptoms, depending on the part of the body affected. Examples include:

Lung infections: that can cause flu-like symptoms such as cough, fever, muscle aches, headaches, and rashes.

Blood infections (septicemia) that can cause chills, fever, nausea and increased heart rate.

Infections of the central nervous system (CNS) (meningitis) can cause persistent pain severe headache, stiff neck and sensitivity to light.

Fungi tests  can also be ordered later or periodically during treatment to assess their effectiveness or to monitor recurrence of infection.

How the fungi test results are interpreted ?

The interpretation of the evidence and fungal tests often require experience in the study of fungi. The results should be carefully considered, along with the signs and symptoms, clinical history and travel history of the person examined.

Superficial infections

Many of the superficial fungal infections are diagnosed based on a physical exam. In addition to the general symptoms, many skin infections have characteristic signs (such as the appearance of the infected nail) and typical places in the body (such as athlete's foot between the toes).

A clinical evaluation can not, however, definitely tell the doctor which microorganism is causing a yeast infection. Sometimes microscopic examination or culture of a sample may be useful in the detection and confirmation of a fungal infection and can help guide treatment.

Examples of superficial infections include:

  •   Yeast infections caused by Candida species
  •   Athlete's foot
  •   Jock itch
  •   Infection on the scalp or hair
  •   Infection of the finger or toe
  •   Ringworm

Deep and systemic infections

In cases of persistent, deep or systemic infections, a definitive diagnosis and more extensive testing may be needed to identify which fungus is causing the infection and to guide treatment is necessary. This usually involves a combination of fungi tests. Examples of some serious fungal infections that can be identified include:

  •    Aspergillosis
  •    Blastomycosis
  •    Coccidioidomycosis
  •    Cryptococcosis
  •    Histoplasmosis



In general, a negative result means that there is no present fungal infection and symptoms are likely due to another cause. A negative test after a person has been treated for a fungal infection means that the therapy has been successful.

Positive results generally indicate that a fungus is present and sometimes identifies the type that causes the infection:

Microscopic examination (potassium hydroxide solution or white calcofluor): In general, if fungal elements are observed, then it is likely that a fungus is causing the symptoms. These tests, however, do not identify the type of fungus.

Cropping care should be taken when interpreting the test results. The interpretation often depends on the type of sample:

For non sterile sites such as the skin, a positive culture typically identify the fungus or fungi present. The identified fungi can be of the type that are disease-causing (pathogenic), the type that only causes disease in people with weakened immune systems (opportunistic) or are part of the normal flora. A mixture of these types can also be present.

       

In the case of sterile, such as blood, cerebrospinal fluid, or tissue samples, will  be properly collected and not contaminated with normal flora . Thus, a positive culture identifies the fungus or fungi that cause infection.

  

Positive antigen test means that it is likely that the fungus tested is the cause of infection.

  

positive result of antibodies in a single sample of blood indicates exposure to a specific fungus, but does not indicate whether it was recent or past exposure. Furthermore, an increase in antibody levels between two serum samples collected 2-3 weeks apart (acute and convalescent) indicates an active or recent fungal infection.

 

Molecular tests: detection of a specific fungus with a molecular test indicates a probable infection with the fungus if the test was performed on a sample of a body site which is barren as blood or tissue.



If a fungus that is causing an infection is not present in sufficient quantity in a sample, the test to detect and / or identify the fungus may be falsely negative.

In the case of antibody tests, some individuals infected with weakened immune systems can not produce antibodies as expected.

Fungal infections can often be distinguished from infections caused by other microorganisms, such as bacteria. In some cases, an infection may be due to bacteria and fungi. Tests that can be used to identify or rule out other causes include:

  • Gram stain: a quick test performed to detect microscopic bacteria and / or fungi in a sample.
  • Bacterial culture: used to rule out a bacterial infection or determine whether there is a concomitant bacterial infection.
  • Smear and culture: ordered when a mycobacterial infection such as tuberculosis is suspected.
  • Blood culture: ordered when septicemia is suspected.

Fungi thrive in moist environments, such as public pools and gyms within sweaty shoes, tight clothing, and skin folds.

Fungal skin infections can be minimized with the use of sandals to limit direct exposure, frequently changing socks, shoes drying and maintenance of wetlands clean and dry body.

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