Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

CRYPTOCOCCUS ANTIGEN

General Information

Lab Order Codes:

CRAG (serum)
INK (CSF)

Synonyms:

Cryptococcal Antigen

CPT Codes:

87899 – Infectious agent antigen immunoassay, not otherwise specified

Test Includes:

Screen for cryptococcal antigen and titer, if positive.

Logistics

Lab Testing Sections:

Microbiology - Sendouts

Referred to:

Fairview University Diagnostic Laboratories- Microbiology (Fairview Code: CRYPTA)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

Performed Monday - Friday 07:30 – 15:00; results are reported within two days.

Special Instructions:

Specimen site and date/time of collection are required for specimen processing.
● Consult Microbiology medical director if repeat titers (i.e.: >1 per week) are desired.

Specimen

Specimen Type:

Blood or CSF

Container:

Blood: red top (plain, no gel) tube

CSF: sterile container

Volume:

Blood: 4 mL (Minimum: 1.2 mL)

CSF: 1 mL (Minimum: 0.5 mL)

Collection:

CSF
1.
Disinfect skin site with 2% tincture of iodine.
2.
Insert needle with stylet at L3 – L4, L4 – L5, or L5 – S1 interspace.
3.
Upon reaching the subarachnoid space, remove the stylet and collect 1 – 2 mL of fluid into each of 2 sterile CSF tubes.
4.
Transport to Microbiology immediately.

Blood
1.
Cleanse venipuncture site with 70% alcohol.
2.
Draw 4 mL (Minimum: 1.5 mL) blood in a red top tube.
3.
Transport to laboratory.

Special Processing:

CSF: Processing dependant on testing requested

● If specimen is for cryptococcal antigen only, store frozen
● If specimen is to be cultured, store in refrigerator, but must arrive within 24 hours.

Blood
: Centrifuge and aliquot 1.3 mL (Minimum: 0.5 mL) serum into a screw-capped round bottom vial. Store at refrigerated temperatures.

Transport/Storage:

Transport specimens to Children’s laboratory at room temperature.

Lab Staff: Ship and store specimens at refrigerated temperatures.

If a culture is ordered on CSF, store refrigerated and ship at room temperature. Fairview University must receive the specimen within 72 hours of collection.

Sample Rejection:

Specimens with transit time to the lab exceeding 2 hours after collection; gross hemolysis; lipemia; turbidity; improperly labeled specimen; insufficient volume; external contamination. If an unacceptable specimen is received, the physician or nursing unit will be notified and another specimen will be requested before the specimen is discarded.

Interpretive

Reference Range:

Negative

Critical Values:

The physician or patient’s nurse will be notified of positive results.

Limitations:

Positive results should be confirmed with culture. Although rare, false-positive results have been reported. False-negative results may occur if a low number of organisms are present in the spinal fluid but the culture may be positive as might be seen early in the course of the disease.

Methodology:

Lateral flow

References:

Fairview Diagnostic Laboratories Web Page September 2013

Cook, JH, and M Pezzlo (1992). Specimen receipt and accessioning. Section 1. Aerobic bacteriology, 1.2.1-4. In HD Isenberg (ed) Clinical Microbiology Procedures Handbook. American Society for Microbiology, Washington DC

Miller, J Michael (1999) A Guide To Specimen Management in Clinical Microbiology, American Society for Microbiology, Washington DC

Miller, J Michael, and HT Holmes (1999) Specimen Collection, Transport, and Storage In PR Murray et al, (ed), Manual of Clinical Microbiology, 7th edition, American Society for Microbiology, Washington DC, pp 33-104

Updates:

9/27/2010: Specimen volume changes.
10/1/2013: CPT update, method change, specimen volume update and transport temp change from frozen to refrigerated.



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