Mold (Aspergillus, Penicillium, Fusarium, etc.) - one or more of the following:
(1) positive microscopic examination in sterile body fluid (CSF, etc.)
(2) positive culture of a specimen taken from sterile body fluid (CSF, etc.)
(3) positive microscopic examination in sputum or broncho-alveolar lavage (BAL)
(4) positive culture from sputum or BAL fluid
(5) positive microscopic examination of tissue collected from a paranasal sinus
(6) positive culture of specimen collected from a paranasal sinus
(7) positive Aspergillus antigen in BAL, CSF or >= 2 blood samples
Cryptococcus - one or more of the following:
(1) positive urine cultures
(2) positive culture from a sterile body fluid (CSF, etc.)
(3) positive microscopic examination in sputum or BAL
(4) positive culture from sputum or BAL fluid
(5) positive antigen in blood AND exclusion of a false positive result associated with:
(5a) rheumatoid factor
(5b) concomitant malignancy
(5c) Trichosporon beigelii
(5d) Stomatococcus mucilaginosis
Candida species - one or more of the following:
(1) positive blood culture
(2) yeast cast in the urine in the absence of a urinary catheter
(3) >= 2 positive urine cultures in the absence of a urinary catheter
(4) positive microscopic examination in sterile body fluid (CSF, etc.)
(5) positive culture of a specimen taken from a sterile body fluid (CSF, etc.)
NOTE: Candida species can colonize the oropharynx and other surfaces without invasion. The presence of pseudohyphae suggests tissue invasion. A large number of organisms associated with inflammatory cells (which may be limited in an immunosuppressed patient) favors infection.
Histoplasma, Blastomyces, Coccidioidomycosis, Paracoccidioidomycosis (dimorphic fungi) - one or more of the following:
(1) positive antigen test in blood, urine or CSF
(2) positive microscopic examination in sputum or BAL
(3) positive culture from sputum or BAL fluid
(4) positive microscopic examination in sterile body fluid (CSF, etc.)
(5) positive culture of a specimen taken from a sterile body site (CSF, etc.)
