Fungal Tests
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- Also Known As:
- KOH Prep
- Fungal Smear
- Culture
- Antigen and Antibody Tests
- Mycology Tests
- Fungal Molecular Tests
- Potassium Hydroxide Preparation
- Calcofluor White Stain

This page was fact checked by our expert Medical Review Board for accuracy and objectivity. Read more about our editorial policy and review process.
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At a Glance
Why Get Tested?
To detect a fungal infection, to determine which specific fungus or fungi are present, and to help guide treatment
When To Get Tested?
When a health care practitioner suspects that you have a skin, lung, or systemic fungal infection; sometimes after treatment to monitor its effectiveness
Sample Required?
The sample collected depends upon the suspected location(s) of the infection. Some examples include: scrapings of the skin, nail and hair samples, body fluids, blood, and/or a tissue biopsy.
Test Preparation Needed?
None
What is being tested?
Fungi are microbes that exist in nature as one-celled yeasts or as branching filamentous molds (also may be spelled “moulds”). Only about 20 to 25 species of fungi are common causes of infection. Fungal tests detect infections and sometimes identify the fungus and help guide treatment.
Fungal infections range from superficial skin infections to serious deep tissue, blood, lung, or systemic diseases.
- Superficial fungal infections are very common. They may cause nail infections or itchy, red, scaly skin infections such as those commonly known as athlete’s foot, jock itch, and ringworm, or yeast infections that cause white patches in the mouth (thrush) or vaginal itching and discharge. According to the Centers for Disease Control and Prevention (CDC), almost 75% of women will have at least one yeast infection in their lifetime.
- Lung, blood, and systemic infections: less commonly, fungi cause serious lung infections, blood infections (septicemia), or systemic infections that can affect any organ in the body. Fungal lung infections typically start with the accidental inhalation of microscopic fungal spores. While anyone can get a serious lung or systemic fungal infection, most affected people will only experience mild to moderate flu-like symptoms. However, people who are immunocompromised, such as those with HIV/AIDS, organ transplant recipients, and people with an underlying condition such as diabetes or lung disease are at an increased risk of having a severe fungal infection, a systemic infection, and/or recurrent infections.
Fungal tests are used to detect and identify fungi in order to diagnose infections and help guide treatment. Fungal testing typically includes a microscopic examination of the sample on a slide, sometimes using a preparation or stain to aid in detection of fungal elements. This may be sufficient to determine that the infection is due to a fungus and, with superficial infections, no further testing may be required.
However, in cases of persistent, deep, or systemic infections when a more definitive diagnosis is needed, the microscopic exam may be followed by additional tests, such as culture and susceptibility testing, antigen or antibody tests, or molecular tests that detect fungal genetic material.
How is the sample collected for testing?
The sample collected depends upon the suspected location(s) of the infection. For superficial infections, the sample may include scrapings of the skin, clipped or shaved nail or hair, vaginal secretions collected with a swab, or a urine sample. For deeper tissue, organ, or systemic infections, the sample may involve the collection of urine, blood from a vein, sputum from the lungs, bone marrow, and/or the collection of a tissue biopsy. If meningitis is suspected, a sample of cerebrospinal fluid is collected.
Common Questions
View Sources
Sources Used in Current Review
Centers for Disease Control and Prevention (December 2, 2014 updated). Types of Fungal Diseases. Available online at http://www.cdc.gov/fungal/diseases/index.html. Accessed August 27, 2016.
Blackwell M. The Fungi: 1, 2, 3 … 5.1 Million Species? American Journal of Botany. 2011; 98(3): 426–438.
American Thoracic Society (October 2013 updated). Aspergillosis. Available online at http://www.thoracic.org/patients/patient-resources/resources/aspergillosis.pdf. Accessed September 5, 2016.
American Thoracic Society (October 2013 updated). Candida Infection of the Bloodstream– Candidemia. Available online at http://www.thoracic.org/patients/patient-resources/resources/candidemia.pdf. Accessed September 5, 2016.
American Thoracic Society (October 2013 updated). Coccidiodomycosis. Available online at http://www.thoracic.org/patients/patient-resources/resources/coccidioidomycosis.pdf. Accessed September 5, 2016.
American Thoracic Society (October 2013 updated). Histoplasmosis. Available online at http://www.thoracic.org/patients/patient-resources/resources/histoplasmosis.pdf. Accessed September 5, 2016.
Mayo Medical Laboratories. Aspergillus (Galactomannan) Antigen, Serum. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/84356. Accessed September 5, 2016.
Centers for Disease Control and Prevention (November 13, 2015 updated.) Aspergillosis. Available online at: http://www.cdc.gov/fungal/diseases/aspergillosis/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (December 28, 2015 updated.) Blastomycosis. Available online at http://www.cdc.gov/fungal/diseases/blastomycosis/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (June 12, 2015 updated.) Candidiasis. Available online at http://www.cdc.gov/fungal/diseases/candidiasis/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (February 13, 2014 updated.) Genital/Vulvovagial Candidiasis (VVC). Available online at http://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (June 12, 2015 updated). Invasive Candidiasis. Available online at http://www.cdc.gov/fungal/diseases/candidiasis/invasive/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (June 29, 2015 updated). Valley Fever (Coccidioidomycosis). Available online at http://www.cdc.gov/fungal/diseases/coccidioidomycosis/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (November 28, 2015 updated). C. neoformans Infection. Available online at http://www.cdc.gov/fungal/diseases/cryptococcosis-neoformans/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (December 16, 2015 updated). C. gatti Infection. Available online at http://www.cdc.gov/fungal/diseases/cryptococcosis-gattii/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (November 21, 2015 updated.) Histoplasmosis. Available online at http://www.cdc.gov/fungal/diseases/histoplasmosis/index.html. Accessed August 27, 2016.
Centers for Disease Control and Prevention (February 13, 2014 updated.) Pneumocystis Pneumonia. Available online at http://www.cdc.gov/fungal/diseases/pneumocystis-pneumonia/index.html. Accessed August 27, 2-16.
Sources Used in Previous Reviews
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 1569, 1570, 1532, 1616.
Forbes, B. et. al. (© 2007). Bailey & Scott’s Diagnostic Microbiology, Twelfth Edition: Mosby Elsevier Press, St. Louis, Missouri. Pp 629-716.
(2008 March 27, Modified). Candidiasis. CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/candidiasis_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Aspergillosis (Aspergillus). CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/aspergillosis_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Blastomycosis. CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/blastomycosis_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Coccidioidomycosis. CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/coccidioidomycosis_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Cryptococcus. CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/cryptococcus_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Dermatophytes (Ringworm). CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/dermatophytes_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Histoplasmosis. CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/histoplasmosis_gi.html. Accessed on 8-14-08.
(2008 March 27, Modified). Sporotrichosis. CDC, Division of Foodborne, Bacterial, and Mycotic Diseases [On-line information]. Available online at http://www.cdc.gov/nczved/dfbmd/disease_listing/sporotrichosis_gi.html. Accessed on 8-14-08.
Lehrer, M. (2006 October 26, Updated). Fungal nail infection. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001330.htm. Accessed on 8-14-08.
Lehrer, M. (2006 October 16, Updated). Tinea Corporis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000877.htm. Accessed on 8-14-08.
Berman, K. (2007 April 12, Updated). Athlete’s Foot. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000875.htm. Accessed on 8-14-08.
Lehrer, M. (2006 October 16, Updated). Tinea capitis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000878.htm. Accessed on 8-14-08.
Berman, K. (2007 April 12, Updated). Jock itch. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000876.htm. Accessed on 8-14-08.
Lehrer, M. (2007 April 12, Updated). Skin lesion KOH exam. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003761.htm. Accessed on 8-14-08.
Berman, K. (2006 October 13, Updated). Wood’s lamp. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003386.htm. Accessed on 8-14-08.
Stokowski, L. (2007 November 20). Fungal Skin and Nail Infections: Practical Advice for Advanced Practice Clinicians. Medscape Nursing Perspectives [On-line information]. Available online at http://www.medscape.com/viewarticle/566002. Accessed on 8-16-08.
Pappas, P. (2007 May 31). Invasive Fungal Infections: Diagnosis, Treatment, and Prophylaxis CME/CE. Medscape [On-line information]. Available online at http://www.medscape.com/viewarticle/556373. Accessed on 8-13-08.
(2005 November, Revision). Fungi. The Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec14/ch180/ch180a.html?qt=fungal%20infection&alt=sh#sec14-ch180-ch180a-1521. Accessed on 8-13-08.
(2005 November, Revision). Fungal Skin Infections. The Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec10/ch120/ch120a.html. Accessed on 8-13-08.
(© 2006-2008). Yeast-Associated Syndromes. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/InfectiousDz/Fungi/Yeasts.html. Accessed on 8-16-08.
(© 2006-2008). Mold-Associated Syndromes. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/InfectiousDz/Fungi/Molds.html. Accessed on 8-16-08.
Ellis, D. (2008 February 7, Modified). Calcofluor White with 10% KOH. Mycology Online [On-line information]. Available online at http://www.mycology.adelaide.edu.au/Laboratory_Methods/Microscopy_Techniques_and_Stains/calcofluor.html. Accessed on 8-16-08.
(March 2011) Mandanas R. Fungal Pneumonia. Medscape Reference Article. Available online at http://emedicine.medscape.com/article/300341-overview. Accessed October 2012.
(May 21 2012) Hidalgo J. Candidiasis, Medscape Reference. Available online at http://emedicine.medscape.com/article/213853-overview. Accessed October 2012.
(October 1, 2012) King J. Cryptococcocus, Medscape Reference. Available online at http://emedicine.medscape.com/article/215354-overview. Accessed October 2012.
American Thoracic Society. Fungal Lung Disease. PDF available for download at http://www.thoracic.org/education/breathing-in-america/resources/chapter-9-fungal-lung-disease.pdf. Accessed October 2012.
(January 5, 2012) Centers for Disease Control and Prevention. Fungal Infections. Available online at http://www.cdc.gov/fungal/. Accessed October 2012.
(March 9, 2011) Rashid M. Tinea in Emergency Medicine. Medscape Reference. Available online at http://emedicine.medscape.com/article/787217-overview. Accessed October 2012.
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