Many clinical laboratories offer “fungal blood cultures” that employ
specialized media designed to enhance the detection of yeast or mold
fungemia. However, it is well-established that specialized fungal blood
culture media are not superior to routine blood culture media for the detection
of Candida fungemia (candidemia) [24,25]. Thus, the main rationale
for the use of fungal blood cultures is to improve detection of
cryptococcal yeast, endemic fungi (Histoplasma capsulatum, Coccidioides
spp., etc) and filamentous fungi (e.g., Aspergillus spp.) in the blood.
Until recently, our institution offered fungal blood cultures using Myco/
F Lytic bottles (Becton Dickinson) designed for use with the BACTEC automated
culture monitoring system. This approach was costly, not only
in terms of reagent costs but also in terms of technical labor. The
highly-enriched and non-selective culture medium needed to be incubated
for up to 30 days before a negative result could be obtained, and
this frequently promoted the growth and eventual detection of skin contaminants
that would not have been detected using routine blood culture
bottles and a 5 to 7 day incubation period. Thus, we reviewed our
experience with this approach to understand whether or not it provided
a significant clinical benefit.