Yeast-Associated Infections

Yeasts cause a spectrum of diseases that range from colonization to uniformly fatal invasive disease. Invasive fungal disease may occur in immunocompromised patients, patients on immunomodulatory therapy or with indwelling devices, and critically ill patients. The species most likely to cause disease include cryptococcus neoformans and candida spp. Manifestations of infections may occur in one or more body sites, and often present with symptoms related to the site of involvement. For more information on fungal diseases, visit the CDC’s fungal diseases site.

  • Diagnosis
  • Background
  • Lab Tests
  • References
  • Related Topics

Indications for Testing

At-risk patients with suspected yeast-associated disease

Laboratory Testing

Yeast-Associated Signs and Symptoms – Pulmonary

Yeast-Associated Signs and Symptoms – Sites Other than Pulmonary

Tests generally appear in the order most useful for common clinical situations. Click on number for test-specific information in the ARUP Laboratory Test Directory.

Fungal Culture 0060149
Method: Culture/Identification


Notify laboratory if Malassezia furfur is suspected

Fungal Stain, KOH with Calcofluor White 2004589
Method: Microscopy

India Ink Stain 2004593
Method: Microscopy

Blood Culture, Fungal 0060070
Method: Continuous Monitoring Blood Culture/Identification

Fungal (Mold/Yeast) Identification 0060163
Method: Identification. Methods may include biochemical, mass spectrometry, or sequencing.

Histoplasma Antigen by EIA, Serum 0092522
Method: Semi-quantitative Enzyme Immunoassay

Histoplasma Galactomannan Antigen Quantitative by EIA, Urine 2009418
Method: Quantitative Enzyme Immunoassay

Histoplasma capsulatum Identification by DNA Probe 0062226
Method: Nucleic Acid Probe

Cryptococcus Antigen, Serum 0050196
Method: Semi-quantitative Enzyme Immunoassay

Cryptococcus Antigen, CSF 0050195
Method: Semi-Quantitative Enzyme Immunoassay

(1,3)-Beta-D-Glucan (Fungitell) 2002434
Method: Semi-Quantitative Colorimetry


Does not detect fungal species that produce very low levels of (1-3) beta-D-glucan (eg, Cryptococcus)

Does not detect Zygomycetes (ie, Absidia, Mucor, and Rhizopus)

Yeast phase of Blastomyces dermatitidis may not be detected

Vaginal Pathogen Panel by DNA Probe 0065153
Method: Qualitative Nucleic Acid Probe

Candida Species by PCR with Reflex to FKS Drug Resistance by Sequencing 2013784
Method: Qualitative Polymerase Chain Reaction/Sequencing

Coccidioides Antibodies Panel, Serum by CF, ID, ELISA 0050588
Method: Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion/Semi-Quantitative Enzyme-Linked Immunosorbent Assay


Negative fungal serology does not rule out possibility of current infection

Coccidioides Antibodies Panel, CSF by CF, ID, ELISA 3000061
Method: Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion/Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Coccidioides immitis Identification by DNA Probe 0062225
Method: Nucleic Acid Probe

Blastomyces dermatitidis Identification by DNA Probe 0062224
Method: Nucleic Acid Probe

Blastomyces dermatitidis Antigen Quantitative by EIA 2002926
Method: Quantitative Enzyme Immunoassay

Blastomyces Antibodies by CF and ID (Temporary Referral as of 08/22/2017) 0050626
Method: Semi-Quantitative Complement Fixation/Qualitative Immunodiffusion

Explify Respiratory Pathogens by Next Generation Sequencing 2013694
Method: Massively Parallel Sequencing


De Rosa FG, Garazzino S, Pasero D, Di Perri G, Ranieri VM. Invasive candidiasis and candidemia: new guidelines. Minerva Anestesiol. 2009; 75(7-8): 453-8. PubMed

Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE, Filler SG, Fisher JF, Kullberg B, Ostrosky-Zeichner L, Reboli AC, Rex JH, Walsh TJ, Sobel JD, Infectious Diseases Society of America. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009; 48(5): 503-35. PubMed

Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, Harrison TS, Larsen RA, Lortholary O, Nguyen M, Pappas PG, Powderly WG, Singh N, Sobel JD, Sorrell TC. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50(3): 291-322. PubMed

General References

Chagas-Neto TC, Chaves GM, Colombo AL. Update on the genus Trichosporon. Mycopathologia. 2008; 166(3): 121-32. PubMed

Cornely OA. Aspergillus to Zygomycetes: causes, risk factors, prevention, and treatment of invasive fungal infections. Infection. 2008; 36(4): 296-313. PubMed

Couturier MR, Graf EH, Griffin AT. Urine antigen tests for the diagnosis of respiratory infections: legionellosis, histoplasmosis, pneumococcal pneumonia. Clin Lab Med. 2014; 34(2): 219-36. PubMed

Durkin M, Connolly P, Kuberski T, Myers R, Kubak BM, Bruckner D, Pegues D, Wheat J. Diagnosis of coccidioidomycosis with use of the Coccidioides antigen enzyme immunoassay. Clin Infect Dis. 2008; 47(8): e69-73. PubMed

Fischer GB, Mocelin H, Severo CB, Oliveira Fd, Xavier MO, Severo LC. Histoplasmosis in children. Paediatr Respir Rev. 2009; 10(4): 172-7. PubMed

Huston SM, Mody CH. Cryptococcosis: an emerging respiratory mycosis. Clin Chest Med. 2009; 30(2): 253-64, vi. PubMed

Kauffman CA. Histoplasmosis. Clin Chest Med. 2009; 30(2): 217-25, v. PubMed

Montenegro BL, Arnold JC. North American dimorphic fungal infections in children. Pediatr Rev. 2010; 31(6): e40-8. PubMed

Parish JM, Blair JE. Coccidioidomycosis. Mayo Clin Proc. 2008; 83(3): 343-48; quiz 348-9. PubMed

Perfect JR. Cryptococcus neoformans: the yeast that likes it hot. FEMS Yeast Res. 2006; 6(4): 463-8. PubMed

Perlroth J, Choi B, Spellberg B. Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Med Mycol. 2007; 45(4): 321-46. PubMed

Saccente M, Woods GL. Clinical and laboratory update on blastomycosis. Clin Microbiol Rev. 2010; 23(2): 367-81. PubMed

Tuon FF, Costa SF. Rhodotorula infection. A systematic review of 128 cases from literature. Rev Iberoam Micol. 2008; 25(3): 135-40. PubMed

Wheat J. Approach to the diagnosis of the endemic mycoses. Clin Chest Med. 2009; 30(2): 379-89, viii. PubMed

Wheat J. Improvements in diagnosis of histoplasmosis. Expert Opin Biol Ther. 2006; 6(11): 1207-21. PubMed

References from the ARUP Institute for Clinical and Experimental Pathology®

Cloud JL, Bauman SK, Neary BP, Ludwig KG, Ashwood ER. Performance characteristics of a polyclonal enzyme immunoassay for the quantitation of Histoplasma antigen in human urine samples. Am J Clin Pathol. 2007; 128(1): 18-22. PubMed

Cloud JL, Bauman SK, Pelfrey JM, Ashwood ER. Biased report on the IMMY ALPHA Histoplasma antigen enzyme immunoassay for diagnosis of histoplasmosis. Clin Vaccine Immunol. 2007; 14(10): 1389-90; author reply 1390-1. PubMed

Crockett DK, Kushnir MM, Cloud JL, Ashwood ER, Rockwood AL. Identification of histoplasma-specific peptides in human urine. Int J Pept. 2012; 2012: 621329. PubMed

Erali M, Pounder JI, Woods GL, Petti CA, Wittwer CT. Multiplex single-color PCR with amplicon melting analysis for identification of Aspergillus species. Clin Chem. 2006; 52(7): 1443-5. PubMed

Hansen J, Slechta S, Gates-Hollingsworth MA, Neary B, Barker AP, Bauman S, Kozel TR, Hanson KE. Large-scale evaluation of the immuno-mycologics lateral flow and enzyme-linked immunoassays for detection of cryptococcal antigen in serum and cerebrospinal fluid. Clin Vaccine Immunol. 2013; 20(1): 52-5. PubMed

Hanson KE, Pfeiffer CD, Lease ED, Balch AH, Zaas AK, Perfect JR, Alexander BD. β-D-glucan surveillance with preemptive anidulafungin for invasive candidiasis in intensive care unit patients: a randomized pilot study. PLoS One. 2012; 7(8): e42282. PubMed

Kushnir MM, Crockett DK, Cloud JL, Ashwood ER, Rockwood AL. Exploratory study of proteins in urine of patients with histoplasma antigenuria. J Chromatogr B Analyt Technol Biomed Life Sci. 2012; 883-884: 147-54. PubMed

Powers AE, Bender JM, Kumánovics A, Ampofo K, Augustine N, Pavia AT, Hill HR. Coccidioides immitis meningitis in a patient with hyperimmunoglobulin E syndrome due to a novel mutation in signal transducer and activator of transcription. Pediatr Infect Dis J. 2009; 28(7): 664-6. PubMed

Powers-Fletcher MV, Hanson KE. Nonculture Diagnostics in Fungal Disease. Infect Dis Clin North Am. 2016; 30(1): 37-49. PubMed

Rickerts V, Khot PD, Ko DL, Fredricks DN. Enhanced fungal DNA-extraction from formalin-fixed, paraffin-embedded tissue specimens by application of thermal energy. Med Mycol. 2012; 50(6): 667-72. PubMed

Slechta S, Hohmann SL, Simmon K, Hanson KE. Internal transcribed spacer region sequence analysis using SmartGene IDNS software for the identification of unusual clinical yeast isolates. Med Mycol. 2012; 50(5): 458-66. PubMed

Yu MK, Rodgers GM. Immune-mediated thrombocytopenia associated with valley fever. Am J Hematol. 2002; 70(1): 81-2. PubMed

Medical Reviewers

Last Update: December 2017