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Subhash Mohan has published a book on Gram Stain: Looking Beyond Bacteria to Find Fungi in Gram Stained Smear (A Laboratory Guide for Medical Microbiology). This book is based on experience containing over 340 colored microscopic images. It contains flow charts, methods and many cases in all groups of fungi describing decision making insight. This book also has a quiz section for practice followed by the answers.

There is also a short conclusion at the end that is worth looking at. The price of the book at the is listed at $56.00US + shipping and handling. However, Subhash is offering the book for $39.00CAN, no taxes or other charges. If interested, please send an e-mail: or call at 416-586-4800 ext. 5438.

Routine microbiology receives clinical specimens for C & S. Many of these specimens require direct smear examination a simple staining procedure such as Gram stain. The routine technologist in microbiology examining Gram smears usually search for bacteria and yeasts in direct smears and may miss the presence of fungi. Fungi present in direct Gram smears may remain undetected due to the lack of experience in mycology. General microbiology staff needs to be aware of and learn to recognize objects other than bacteria in direct gram smears.

A lot of times clinical specimens sent to general microbiology laboratory containing fungi were never requested for mycological study but for C & S only. Direct Gram smears from these specimens also contained FE but were not picked up by the smear reader for several reasons.

Although no mycology textbook or a journal describes or suggests finding fungi in clinical specimens using Gram stain. However, I believe that with little effort and full concentration, one can easily suspect fungi when present in the Gram stained smears. I have included some of the important images of fungi stained by Gram stain for your convenience. I hope you like them.

Click circular thumbnails for larger images and descriptions.

Candida albicans Candida albicans Candida albicans
Sporothrix schenckii Exophiala jeanselmei Histoplasma capsulatum
Histoplasma capsulatum Histoplasma capsulatum Torulopsis glabrata
Malassezia furfur Coccidioides immitis Coccidioides immitis
Aspergillus flavus Aspergillus flavus Aspergillus fumigatus
Aspergillus fumigatus Aspergillus terreus Aspergillus fumigatus
Aspergillus niger Aspergillus fumigatus Paecilomyces lilacinus
Ramichloridium mackenziei Ramichloridium mackenziei Ramichloridium mackenziei
Fusarium species Cryptococcus neoformans Cryptococcus neoformans
Rhizopus species Rhizopus species Rhizopus species
Blastomyces dermatitidis Blastomyces dermatitidis Rhinosporidium seeberi
Rhinosporidium seeberi Penicillium marneffei Penicillium marneffei
Penicillium species Acanthamoeba cysts Acanthamoeba cysts
Microsporidia Microsporidia Microsporidia
Prototheca wickerhamii Prototheca wickerhamii Prototheca wickerhamii


Copyright 1999-2007 Department of Microbiology, Mount Sinai Hospital, Toronto, Canada. All rights reserved.