It is important that good quality samples are sent to the laboratory otherwise results may be misleading and repeat specimens indicated.
- Skin and Nail Specimens should be collected into a Dermapak or similar black card packet. If these are not available then a sterile, plain, plastic universal may be used. Please do not use ad-hoc packets or sellotape as culture may fail due to overgrowth of contaminating saprophytic fungi. Microscopy will be impeded by specimen affixed to sellotape. If toothbrushes are used to sample scalp skin, please note this prevents microscopic examination of the sample. A scalp skin scraping or hair pluck is preferable.
- Swabs from mucous membranes : These should be in plain transport medium, as yeasts die rapidly in dry swabs and use of charcoal swabs interferes with microscopic examination.
- Oral rinses are the best specimen for oral candidosis. Ask the patient to rinse 10ml sterile saline in their mouth for about 30sec then spit back into a sterile universal tube and send.
Clean lesions with surgical spirit or 70% alcohol before collecting samples. This minimises contamination and is an aid to microscopy if greasy ointments or powders have been applied
Be sure to include as much material as possible so that full laboratory investigations can be carried out. It is always useful to have enough skin or nail to repeat the culture if necessary
- Skin : Collect material by scraping from the edges of the lesions, ideally with a scalpel blade.
- Nail : If possible, collect the subungual debris in addition to nail clippings. Sample the discoloured, dystrophic or brittle parts of the nail only, sampling as far back as possible from the distal part of the nail.
- Hair : Pluck hairs from the affected area with forceps (infected hairs come out easily) and scrape the scalp with a scalpel. Preferably, the sample should include hair roots, the contents of plugged follicles and skin scales. Hair cut with a scissors is unsatisfactory as the focus of infection is usually below or near the surface of the scalp. Sterile toothbrushes may be useful but preclude microscopy on the sample.
- Samples from mucous membranes : Use swabs to collect material from Candida infections of the mouth or vagina.
The request forms for Mycology for superficial samples have an integral specimen bag. The address for the return report should be clearly indicated. Details of previous treatment should be included on the request form where possible as they may affect both the appearance of the fungus and also the likelihood of a positive culture result.
Storage of specimens
Skin and nail specimens should be stored at room temperature, as dermatophyte fungi may be killed at 4 - 6 oC. Swabs from mucous membranes should be stored in the refrigerator prior to despatch.
Supply of Dermapaks and forms
- GP's dealing with LGI - further forms and Dermapaks will be issued with the hard copy report of the microscopy results. GP's dealing with Bradford - order on consumables request slips.
- Dermatology clinics/ wards - order Dermapaks from manufacturer and forms from Saxton Gardens
- Irregular Ward users - please contact the laboratory for us to issue you with a few forms and Dermapaks
- Other customers - please contact the laboratory.