Effective June 1, 2026, Corewell Health Microbiology Laboratory in Southeast Michigan is updating specimen collection criteria for body fluid specimens. Microbiology will no longer accept red top vacutainer tubes as a collection device for body fluids (i.e. synovial fluid, pleural fluid, peritoneal fluid, etc). Collection criteria information has been updated in Corewell’s Lab Test Directory to reflect this change. Test order for body fluid cultures is LAB2111016 (aerobic culture) and commonly accompanied by LAB233 (anaerobic culture).
Orthopaedic
Effective December 2, 2024 at 08:00 AM, Corewell Health West Laboratory Coagulation Department will be updating the reference range for several assays. The following will be impacted by these changes:
APTT testing for the BCS XP analyzers will be updating to 22.0 – 27.0 seconds.
This will include the following tests:
- aPTT Direct Thrombin Inhibitor (LAB1230880) (APTT-DTI)
- Mixing Studies, aPTT (LAB326)
- APTT (LAB325)
- APTT Heparin Neutralization (LAB3377)
Effective December 2, 2024 at 08:00 AM, the Corewell Health West and South Coagulation Departments will be updating the reference range of the Fibrinogen Level (LAB 314) to 190-450 mg/ dL.
Questions may be directed to the Coagulation Laboratory using the Contact Us link above.
The management of sinusitis is often aided by bacterial and fungal cultures from which Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and occasionally aerobic Gram-negative bacilli are the most commonly recovered pathogenic organisms. The Corewell Health West Microbiology Lab has several orders available for culturing sinus specimens collected as fluid aspirates, tissue, or swabs. Though more challenging to collect, aspirates are preferred over swab cultures that often grow mixed normal upper respiratory flora for which it is difficult to interpret the clinical significance.
| Available Sinus Culture Orders | Default Specimen Type | Comments |
| Body Fluid Culture [LAB2111016]
Respiratory Culture [LAB3095] Tissue Culture [LAB2111173] |
Aspirated fluid
Swabbed collection Tissue |
For aerobic bacteria |
| Fungal Culture [LAB240] | Aspirated fluid or tissue, preferred
Swabbed collection |
For fungal organisms |
| Anaerobic Culture [LAB233] | Aspirated fluid or tissue* | For anaerobic bacteria |
Cell Count w/ Differential if indicated, Cerebrospinal Fluid [LAB2111025] and Cell Count with Differential, Cerebrospinal Fluid (Pediatric Oncology) [LAB212] currently result nucleated cell counts as a White Blood Cell (WBC) count.
Effective Tuesday, August 16, 2022, the WBC component will be removed and instead reported as a Total Nucleated Cell (TNC) Count for CSF.
Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids. This component will be displayed in Epic as an absolute PMN count, body fluid.
• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.
• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).
• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).
• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.
• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS
Effective February 24, 2021, Cerebrospinal Fluid (CSF) Xanthochromia results of “Present” will be considered a critical laboratory value.
This change was approved by the MEC and driven by a collaboration between neurology and laboratory departments to assist in expediting the diagnosis and management of patients with possible subarachnoid hemorrhage (SAH).
