Microbiology Laboratory Tests: I-L
Microbiology
Influenza (Culture – Isolation)
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Test Includes: Cell Culture | |
Reporting |
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Results Available: 2-14 days | Contact #s: 512-458-7594 |
Reference |
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Method: Cell Culture | |
Turnaround Time: 2-14 days | Reference Range: No influenza virus isolated |
Limitations: | Interpretation: A result of “No influenza virus isolated” does not necessarily mean absence of disease. The success of virus isolation depends a great deal on the submission of the proper specimen, collected at the right time, adequately maintained, and shipped with the least possible delay. |
Specimen Requirements |
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Specimen Collection: Specimens should be collected at an appropriate anatomic site and at the proper time after infection because viruses are generally shed for only a short period of time. Refer to Specimen Collection by Type table for additional instructions. | Sample Type: See preferred specimens |
Volume/Amount Required: Swabs in 2-4 mL of influenza transport media. | Preferred Specimen: Throat Swab, Nasopharyngeal Secretions, Nasopharyngeal aspirate, Nasal wash, Nasal swab. |
Collection/Preservation: Influenza transport media, Viral transport media. | Storage Instructions: Arriving < 72 hours after collection, store and send at 2-8° C. Arriving > 72 hours after collection, store and send at -70° C (dry ice). |
Causes for Rejection: Specimens submitted on a preservative such as formalin. | Sample Container: Sterile container |
Sample Test Kit: | Availability: Monday - Friday |
Diagnostic Information: Specimens are inoculated onto cell culture monolayers. If characteristic CPE or hemadsorption is observed, confirmation of identification will be performed. | |
Specimen Submission |
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Required Request Form: G-2V | Specimen Handling: |
Transport Temperature: Arriving <72 hours: 2-8 °C (refrigerated) Arriving >72 hours send on dry ice |
Shipping Requirements: Ship specimens in compliance with governmental regulations. |
Billing |
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CPT Code: 87252, 87253 | Fees: |
Microbiology
Influenza (Culture – Typing)
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Test Includes: Immunofluorescence | |
Reporting |
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Results Available: 2-14 days | Contact #s: 512-458-7594 |
Reference |
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Method: Immunofluorescence | |
Turnaround Time: 2-14 days | Reference Range: By report |
Limitations: | Interpretation: |
Specimen Requirements |
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Specimen Collection: | Sample Type: |
Volume/Amount Required: If transporting on dry ice, send 1-2 mLs. | Preferred Specimen: Cell culture isolate with CPE. |
Collection/Preservation: | Storage Instructions: If shipment of isolate will be delayed, store at -70° C. |
Causes for Rejection: | Sample Container: Sterile cryovial. |
Sample Test Kit: | Availability: Monday - Friday |
Diagnostic Information: Typing is based on immunofluorescence test using influenza A and influenza B monoclonal antibodies. | |
Specimen Submission |
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Required Request Form: G-2V | Specimen Handling: |
Transport Temperature: Frozen isolate: on dry ice | Shipping Requirements: Ship specimens in compliance with governmental regulations. |
Billing |
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CPT Code: 86710 | Fees: |
Microbiology
Isopora species (Microscopic – Direct Wet Smears Concentration)
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Test Includes: Microscopic examination | |
Reporting |
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Results Available: 3 days | Contact #s: (512) 458-7560 |
Reference |
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Method: Microscopic examination | |
Turnaround Time: 3 days | Reference Range: No parasites found |
Limitations: | Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted. |
Specimen Requirements |
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Specimen Collection: Feces | Sample Type: Feces |
Volume/Amount Required: 15 mL liquid stool, 15 g stool | Preferred Specimen: Feces, formalin preserved |
Collection/Preservation: Collect fresh stool in a clean, dry container. Immediately transfer stool to formalin preservative. Transport at ambient temperature. | Storage Instructions: Ambient temperature |
Causes for Rejection: Unpreserved stool > 5 hours old. | Sample Container: Formalin transport for parasites. |
Sample Test Kit: | Availability: Monday-Friday |
Diagnostic Information: Fecal specimens must be sent in formalin. Specimens are accepted from public health officials. Referred material accepted from hospital, private, and reference labs. | |
Specimen Submission |
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Required Request Form: G-2B | Specimen Handling: Handle body fluids using universal precautions. Formalin is a poison, handle with care. |
Transport Temperature: Ambient temperature | Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens. |
Billing |
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CPT Code: 87015 | Fees: |
Microbiology
Isopora species (Microscopic – Acid Fast Stain)
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Test Includes: Microscopic Examination | |
Reporting |
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Results Available: 3 days | Contact #s: (512) 458-7560 |
Reference |
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Method: Microscopic Examination | |
Turnaround Time: 3 Days | Reference Range: No parasites found |
Limitations: | Interpretation: No parasites found indicates that there were no visible parasites in the specimen submitted. |
Specimen Requirements |
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Specimen Collection: feces | Sample Type: feces in formalin |
Volume/Amount Required: 15 mL liquid stool, 15 g stool |
Preferred Specimen: Formalin preserved feces. |
Collection/Preservation: Collect stool and immediately place in formalin preservative. Ship at ambient temperature. | Storage Instructions: Ambient temperature. |
Causes for Rejection: Unpreserved stool > 5 hours old | Sample Container: Formalin transport for parasites |
Sample Test Kit: | Availability: Monday-Friday |
Diagnostic Information: Fecal specimens must be sent in formalin. Specimens are accepted from public health officials. Referred material accepted from hospital, private, and reference labs. | |
Specimen Submission |
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Required Request Form: G-2B | Specimen Handling: Handle body fluids using universal precautions. Formalin is a poison, handle with care. |
Transport Temperature: Ambient temperature. | Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens. |
Billing |
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CPT Code: 87177 | Fees: |
Microbiology
Legionellosis Culture (Identification)
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Test Includes: Conventional biochemicals; Direct Immunofluorescence Antibody Test (DFA) | |
Reporting |
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Results Available: 7-14 days | Contact #s: (512) 458-7582 |
Reference |
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Method: Conventional biochemicals; Direct Immunofluorescence Antibody Test (DFA) | |
Turnaround Time: 7-14 days | Reference Range: By report |
Limitations: Organism must be viable for culture studies to be performed. | Interpretation: By report |
Specimen Requirements |
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Specimen Collection: | Sample Type: Pure culture |
Volume/Amount Required: one specimen per patient | Preferred Specimen: Pure cultures on appropriate media. |
Collection/Preservation: Ambient temperature | Storage Instructions: Ambient temperature |
Causes for Rejection: Name on tube/specimen do not match; Broken in transport. | Sample Container: Agar slant in screw cap tube |
Sample Test Kit: | Availability: Monday-Friday |
Diagnostic Information: Legionella requires cysteine for growth and should be submitted on a media like BCYE agar to insure viability. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: Infectious agent, biosafety level 2 |
Transport Temperature: Ambient temperature | Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents. |
Billing |
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CPT Code: 87077 | Fees: |
Microbiology
Legionellosis (Serological - Immunofluorescence)
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Test Includes: | |
Reporting |
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Results Available: 3-5 days | Contact #s: |
Reference |
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Method: IFA | |
Turnaround Time: 3-5 days | Reference Range: < 1:64 (Nonreactive) |
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. | Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection. |
Specimen Requirements |
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Specimen Collection: Venipuncture | Sample Type: Serum |
Volume/Amount Required: 2 mL Serum | Preferred Specimen: Paired Sera; Single Serum |
Collection/Preservation: Samples that will be delivered to the laboratory within 8 hours of collection may be transported at room temperature in the original blood collection tube. If the samples are going to be shipped and will be delivered to the laboratory within 48 hours of collection, sera must be separated from the blood and shipped on cold packs, between 2° and 8°C. If the serum samples will not be delivered to the laboratory within 48 hours of collection at these temperatures, then the samples must be frozen at -20°C or lower and shipped on dry ice. | Storage Instructions: Separated serum may be held at 2-8°C, or frozen at -20°C. |
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing, specimens received with extended transit time, or received at incorrect temperature. | Sample Container: Red top or tiger top tube |
Sample Test Kit: | Availability: Test run every Tuesday and Thursday |
Diagnostic Information: A single serum will be tested only if three or more weeks after onset. Single titers of <1:64 are considered Nonreactive. Single titers between 1:64 and 1:128 are considered Nonreactive, but may warrant follow-up testing. Single titers >1:256 are considered evidence of infection at an undetermined time. A fourfold or greater titer increase between acute and convalescent sera provides evidence of recent infection. The test is performed twice per week. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: Use Universal Precautions |
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection. Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection. | Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice. |
Billing |
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CPT Code: 86713 | Fees: |
Microbiology
Leishmaniasis (PCR – CDC through TDSHS)
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Test Includes: Specimens forwarded by TDSHS to CDC with prior arrangement | |
Reporting |
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Results Available: | Contact #s: |
Reference |
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Method: | |
Turnaround Time: | Reference Range: |
Limitations: | Interpretation: |
Specimen Requirements |
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Specimen Collection: | Sample Type: |
Volume/Amount Required: | Preferred Specimen: |
Collection/Preservation: | Storage Instructions: |
Causes for Rejection: | Sample Container: |
Sample Test Kit: | Availability: |
Diagnostic Information: Specimens forwarded by TDSHS to CDC with prior arrangement. Please call 512-458-7560 to make arrangements and instructions on specimen type and shipping temperatures. If culture is positive, PCR can be performed for speciation. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: |
Transport Temperature: | Shipping Requirements: |
Billing |
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CPT Code: 87797 | Fees: |
Microbiology
Leishmaniasis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes: | |
Reporting |
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Results Available: | Contact #s: |
Reference |
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Method: | |
Turnaround Time: 3 weeks | Reference Range: >1:16 (Nonreactive) |
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. | Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection. |
Specimen Requirements |
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Specimen Collection: Venipuncture | Sample Type: Serum |
Volume/Amount Required: 10 mL whole blood | Preferred Specimen: Paired Sera |
Collection/Preservation: Red top or tiger top tube | Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C |
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing | Sample Container: Red top or tiger top tube |
Sample Test Kit: | Availability: |
Diagnostic Information: Specimens forwarded by TDSHS to CDC with prior arrangement. Prior notification is requested (512) 458-7760. A detailed patient history is required. Titers of >1:16 are considered positive. The diagnosis of dermal or cutaneous leishmaniasis is more difficult than the visceral form, since a detectable immune response is often absent. Cross reactions may occur with Chagas’ disease, malaria or schistosomiasis, so positive serological results provide only suggestive support for the diagnosis. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: Use Universal Precautions |
Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen). | Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice. |
Billing |
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CPT Code: 86717 | Fees: |
Microbiology
Leishmaniasis (Microscopic – Giemsa Stain)
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Test Includes: | |
Reporting |
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Results Available: | Contact #s: |
Reference |
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Method: | |
Turnaround Time: 24 hours | Reference Range: |
Limitations: | Interpretation: |
Specimen Requirements |
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Specimen Collection: | Sample Type: |
Volume/Amount Required: | Preferred Specimen: Tissue |
Collection/Preservation: | Storage Instructions: |
Causes for Rejection: | Sample Container: |
Sample Test Kit: | Availability: |
Diagnostic Information: Specimens examined by TDSHS follow up cultures will be forwarded by TDSHS to CDC with prior arrangement. | |
Specimen Submission |
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Required Request Form: G-2B | Specimen Handling: |
Transport Temperature: Ambient (Room) temperature | Shipping Requirements: |
Billing |
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CPT Code: 87177 | Fees: |
Microbiology
Leptospirosis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes: | |
Reporting |
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Results Available: | Contact #s: |
Reference |
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Method: | |
Turnaround Time: 3 weeks | Reference Range: Nonreactive |
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. | Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection. |
Specimen Requirements |
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Specimen Collection: Venipuncture | Sample Type: Serum |
Volume/Amount Required: 10 mL whole blood | Preferred Specimen: Paired Sera |
Collection/Preservation: Red top or tiger top tube | Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C |
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing | Sample Container: Red top or tiger top tube |
Sample Test Kit: | Availability: |
Diagnostic Information: Prior notification is requested (512) 458-7760. A detailed patient history is required. Sera are sent to the CDC. Specimens positive in the Indirect Hemagglutination Test, qualitative screening test, are confirmed with a quantitative Microagglutination Test against a battery of antigens. A fourfold increase in titer is evidence of current infection. Extensive cross-reactions among leptospiral antigens are frequent. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: Use Universal Precautions |
Transport Temperature: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice. | Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice. |
Billing |
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CPT Code: 86720 | Fees: |
Microbiology
Listeriosis Culture–(Isolation)
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Test Includes: Conventional biochemicals. | |
Reporting |
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Results Available: 7-21 days | Contact #s: (512) 458-7582 |
Reference |
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Method: Conventional biochemicals. | |
Turnaround Time: 7-21 days | Reference Range: No Listeria monocytogenes isolated |
Limitations: Organism must be viable in order to culture. | Interpretation: Isolation of Listeria monocytogenes should always be considered significant. |
Specimen Requirements |
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Specimen Collection: Venipuncture. | Sample Type: Blood; Tissue. |
Volume/Amount Required: 10 mL of whole blood, small piece tissue | Preferred Specimen: Blood; Tissue |
Collection/Preservation: Blood may be kept at ambient temperature or refrigerated. Do not freeze whole blood. Refrigerate tissue. | Storage Instructions: Do not freeze whole blood. Blood may be kept at ambient temperature or refrigerated. Refrigerate tissue. |
Causes for Rejection: No identifying marks on sample and/or paperwork. | Sample Container: Tiger or red top vacutainer, sterile leak-proof container. |
Sample Test Kit: | Availability: Tested Monday – Friday. |
Diagnostic Information: See Aerobic Bacterial Culture (Isolation). | |
Specimen Submission |
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Required Request Form: G-2B | Specimen Handling: Handle body fluids using universal precautions. |
Transport Temperature: Tissue 2-8 ° C; Blood 2-25° C |
Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens. |
Billing |
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CPT Code: 87046 | Fees: |
Microbiology
Listeriosis Culture –(Identification)
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Test Includes: Conventional biochemicals | |
Reporting |
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Results Available: 4-21 days | Contact #s: (512) 458-7582 |
Reference |
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Method: Conventional biochemicals | |
Turnaround Time: 4-21 days | Reference Range: By report |
Limitations: Organism must be viable for culture studies. | Interpretation: Identification of Listeria monocytogenes should always be considered significant. |
Specimen Requirements |
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Specimen Collection: Dependent upon source of sample. | Sample Type: Pure culture. |
Volume/Amount Required: one specimen per patient. | Preferred Specimen: Pure culture on agar slant. |
Collection/Preservation: May be kept at ambient temperature. | Storage Instructions: Store at ambient temperature. |
Causes for Rejection: No identifying marks on sample and/or paperwork. | Sample Container: Dependent upon type of transport. |
Sample Test Kit: | Availability: Tested Monday – Friday. |
Diagnostic Information: See Aerobic Bacterial Culture, (Identification) | |
Specimen Submission |
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Required Request Form: G-2B | Specimen Handling: Infectious agent, Biosafety level 2. |
Transport Temperature: Ambient temperature | Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents. |
Billing |
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CPT Code: 87077 | Fees: |
Microbiology
Listeriosis Culture (Typing)
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Test Includes: Isolates from outbreaks are sent to the CDC for typing. | |
Reporting |
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Results Available: Dependent on CDC report | Contact #s: (512) 458-7185 |
Reference |
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Method: Serotyping, PFGE | |
Turnaround Time: Dependent on CDC report | Reference Range: By report |
Limitations: | Interpretation: |
Specimen Requirements |
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Specimen Collection: | Sample Type: Pure cultures |
Volume/Amount Required: | Preferred Specimen: Pure cultures. |
Collection/Preservation: | Storage Instructions: Ambient temperature |
Causes for Rejection: Insufficient information, Name on tube/form do not match. | Sample Container: Agar slant in screw cap tube. |
Sample Test Kit: | Availability: Monday-Friday |
Diagnostic Information: Isolates from outbreaks are sent to the CDC for typing. Molecular typing performed at TDH Request molecular typing by indicating PFGE on submission form Request serotyping on submission form and include clinical history to be forwarded to the CDC. | |
Specimen Submission |
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Required Request Form: G-2B | Specimen Handling: Infectious agent, Biosafety level 2 |
Transport Temperature: Ambient temperature | Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents. |
Billing |
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CPT Code: 87147 | Fees: |
Microbiology
Loiasis (Microscopic – Direct Giemsa Stains)
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Test Includes: Microscopic examination | |
Reporting |
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Results Available: 1 day | Contact #s: (512) 458-7560 |
Reference |
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Method: Microscopic examination | |
Turnaround Time: 24 hours | Reference Range: No parasites found. |
Limitations: | Interpretation: No parasite found indicates that there were no visible parasites in the specimen submitted. |
Specimen Requirements |
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Specimen Collection: venipuncture | Sample Type: Blood |
Volume/Amount Required: 20 mL whole blood | Preferred Specimen: Blood Purple Top collected between 10 am and 2 pm. |
Collection/Preservation: Collect blood by venipuncture, preferably between 10 am and 2 pm, in a purple top vacutainer tube. | Storage Instructions: Ambient temperature |
Causes for Rejection: Incorrect collection tube, insufficient sample | Sample Container: Purple top vacutainer |
Sample Test Kit: | Availability: Monday-Friday |
Diagnostic Information: 2 thin and 2 thick smears should be examined. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: Handle body fluids using universal precautions. |
Transport Temperature: Ambient temperature | Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens. |
Billing |
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CPT Code: 87102 | Fees: |
Microbiology
Lymphocytic Choriomeningitis (Serological – Forwarded by TDSHS to CDC for testing.)
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Test Includes: | |
Reporting |
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Results Available: | Contact #s: |
Reference |
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Method: | |
Turnaround Time: 3 weeks | Reference Range: Nonreactive |
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. | Interpretation: Nonreactive indicates that the patient does not have detectable antibody to the infectious agent. Reactive indicates that the patient has detectable antibody to the infectious agent, and depending on the clinical picture, may have a current or past infection. |
Specimen Requirements |
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Specimen Collection: Venipuncture, Spinal Tap | Sample Type: Serum, CSF |
Volume/Amount Required: 10 mL whole blood, 1.0 mL CSF | Preferred Specimen: Paired Sera; Spinal Fluid |
Collection/Preservation: Red top or tiger top tube, sterile collection tube for CSF | Storage Instructions: Do not freeze or refrigerate whole blood. Separated serum may be held at 2-8°C. Immediately freeze CSF. |
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing | Sample Container: |
Sample Test Kit: | Availability: |
Diagnostic Information: Sera or CSF are forwarded to the CDC. | |
Specimen Submission |
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Required Request Form: G-2A | Specimen Handling: Use Universal Precautions |
Transport Temperature: Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen). | Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice. |
Billing |
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CPT Code: 86790 | Fees: |