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CSF Fungal Infection Tests

Last updated March 23, 2018

CSF Fungal Infection Tests are a series of tests to identify mycoses in cerebrospinal fluid.


What are the other Names for this Test? (Equivalent Terms)

  • Calcofluor White Stain CSF Tests
  • Potassium Hydroxide Preparation Cerebrospinal Fluid Tests
  • Potassium Hydroxide Preparation CSF Tests

What is CSF Fungal Infection Test? (Background Information)

  • CSF Fungal Infection Test is a common term for a variety of test methods to detect the presence of fungus in a cerebrospinal fluid (CSF) sample. These methods may include smear test, antigen detection through molecular testing methods and culture, antibody detection test, and fungal culture
  • Fungi (plural for fungus) are a diverse, complex group of microscopic organisms. A small subset may cause diseases that, in healthy individuals, are usually mild. However, those with weakened immune systems may experience severe illness. Over 50,000 different species of fungi exist in nature. Of these, less than 200 species can infect humans and only 50 commonly do so
  • Fungi undergo a complex, two-phase life cycle. During their vegetative phase, fungi grow and develop. They then reproduce during their reproductive phase
  • Yeasts are fungi that are single-celled and grow filaments during their reproductive phase. Molds are multi-celled and filamentous throughout their life cycles
  • Many disease-causing fungi switch between yeast and mold forms depending on the temperature of their surroundings. At room temperature (25°C), they grow as multicellular molds. They then convert to single-celled yeasts when they enter a human host (body temperature at 37°C)
  • Fungal infections are called mycoses and they can infect different parts of the body. They fall into any of the 3 categories:
    • Superficial mycoses of the skin and nails
    • Subcutaneous mycoses beneath the skin
    • Systemic mycoses involving multiple organs and organ systems      
  • Superficial and subcutaneous mycoses are fairly common. Examples include jock itch, ringworm, and athlete’s foot, which are caused by Trichophyton species. Other examples include genital infections caused by Candida species
  • Systemic mycoses are most commonly observed in those with underdeveloped or weakened immune systems. These include individuals affected by HIV infection, undergoing cancer and immunosuppressant therapy, etc.
  • CSF Fungal Infection Tests are a series of tests to identify mycoses in cerebrospinal fluid. Different tests are performed depending on the type of mycosis
  • Tests for superficial and subcutaneous mycoses include:
    • Potassium hydroxide (KOH) prep: Microscopic observation of a sample for structures belonging to fungi
    • Calcofluor stain: Dye that stains fungal structures
    • Fungal culture: Tests for growth of a sample in media under fungi-specific conditions. This test yields slower results, but allows for susceptibility testing
  • Tests for systemic mycoses include:
    • Susceptibility tests: Applying various antifungal medications to a fungal culture to determine the most effective treatment for an individual’s mycosis
    • Antigen tests: Identify various structures specific to fungi
    • Antibody tests: Detection of specific antibodies created by the immune system upon exposure to fungi
    • Genetic material tests: The use of PCR to detect traces of specific DNA and RNA that fungi are known to possess, but that which is absent in humans

What are the Clinical Indications for performing the CSF Fungal Infection Tests?

Following are the clinical indications for performing CSF Fungal Infection Tests:

  • Fever, chills
  • Cough
  • Trouble breathing
  • Nausea
  • Severe headaches
  • Stiff muscles and neck

How is the Specimen Collected for CSF Fungal Infection Tests?

Following is the specimen collection process for CSF Fungal Infection Tests:

Sample required: Cerebrospinal fluid (CSF)

Process: Insertion of a thick needle into the lower back (lumbar puncture).

Preparation required: No special preparation is needed prior to the test.

What is the Significance of the CSF Fungal Infection Test  Result?

A positive CSF Fungal Infection Test may indicate a fungal infection. The species most commonly found in CSF include:

  • Candida albicans
  • Histoplasma capsulatum
  • Coccidioides immitis
  • Cryptococcus neoformans
  • Members of the order Mucorales
  • Paracoccidioides brasiliensis
  • Sporothrix schenckii

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Evolutionarily, fungi are very closely related to humans. This makes fungal infections difficult to treat because the number of specific ways a drug can target a fungus, but not a human, is limited

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 7, 2015
Last updated: March 23, 2018