Ringworm cultures: red does not always mean infected!

Let’s continue on our ringworm series of posts! Today, we’ll focus on ringworm cultures. Many of the shelters I visited last year were doing their own. And I was told once by a technician that “when the medium turns red, it means that the animal is infected.” Must admit I was usually outsourcing those tests to an external reference lab when I was at the vet faculty in Paris, but I thought: “Ok, let’s have a look in the literature and see what they say about these tests.”

Here is what I found:

-          These cultures are usually realized on a Dermatophyte Test Medium (DTM). It consists of a nutrient medium plus inhibitors of bacterial growth and phenol red as a pH indicator.

About the medium

-          Several variants are available, but despite some claim to speed growth the culture, this has not been found clinically significant.

-          DTM containers should be loosely covered and placed in a plastic bag , to prevent dessication, cross-contamination and mite infestation.

-          Incubation should be done at room temperature, between 21 to 23.8ºC.

-          No need to incubate cultures in the dark: light exposure will not adversely affect fungal growth.

About the interpretation

-          Dermatophyte colonies may appear as soon as 5 to 7 days post-inoculation. They almost develop within 14 days, assuming the animal has not been treated. For an animal that has been treated, it’s better to wait up to 21 days.

-          Most often, large number of colonies will appear on the plate if the animal is truly infected.     

-          Plates should be inspected daily for a color change of the medium to red and growth of a white fungal colony. Change of color confirms that a fungi is growing but…

-          … all fungal growth, including non pathogens, will lead to this red color change! Dermatophyte colonies are however never green, gray, brown or black.

-          An immediate red color change is NOT definitive for pathogenic fungi. Non pathogen fundi can indeed appear grossly identical to those of dermatophyte colonies.

-          Suspect colonies MUST be examined microscopically. After 7-10 days of growth, most colonies will begin to produce spores, whose morphology will allow specific identification of pathogens (see here)

-          If spores are not visible, the procedure should be repeated 4 to 7 days later.

-          A suspect colony that fails to produce spores or is difficult to identify should be sent to a qualified diagnostic lab.

So RED does not mean positive and it is important to confirm this finding under the microscope. As you can understand then, a definitive diagnosis of ringworm is not something easy to reach. Recently however, a new DNA test became available, and might make the procedure much easier. Wait and see then! 

Remember we are all part of the same PRO community! Don’t hesitate then: share with us your experiences, ask your questions and let us know what you think! Social networks enable us to keep the discussion going, so whether you are a Facebooker or a Twitter-addict, you can – and should!- be part of it!

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