Pathology staff will coordinate processing as rapidly as possible (≤ 24 hours).

1. Histopathological specimen will be stained with hematoxylin and eosin (H&E) and GMS/PAS stains and evaluated for (1) presence of fungal elements; (2) presence of fungal elements in viable or non-viable tissue; (3) presence of angioinvasion.
2. Microbiological specimen will be cultured for aerobes, anaerobes, and fungi.
3. Mycobacterial and/or viral cultures will not be done routinely under this protocol but may be done with special request.

NOTE:

Fungus can take up to six weeks to grow in culture medium. Therefore, it is recommended that the cultures be checked frequently for two weeks; then once a week for four additional weeks before they are considered final. In addition, wounds without recurrent tissue necrosis may have mold colonization and not a true infection.41 Tissue preparation for culturing typically destroys the ribbon-like hyphal elements of fungi belonging to the order Mucorales, reducing growth. The microbiology laboratory should be notified that an IFI is suspected so samples are handled appropriately to maximize culture yield.