India Ink Test

The India ink preparation (test) is a rapid microscopic test used primarily to detect encapsulated yeasts, especially Cryptococcosis caused by Cryptococcus neoformans and Crytococcus gatti. This test is a simple negative staining technique (meaning it stains the background rather than the organism) used in the microbiology laboratory.

India ink contains fine carbon particles that do not penetrate the fungal capsule. The polysaccharide capsule will exclude the particles of ink, and the capsule will appear as a clear halo around the organism.

The India ink preparation is examined under the light microscope, first with 10X to scan slide for yeast cells, then with 40X for detailed examination. Oil immersion (100X) is generally unnecessary.

The test is most commonly performed on cerebrospinal fluid (CSF) from patients suspected of having Cryptococcus neoformans

The India preparation has largely been replaced in many laboratories by the Cryptococcus antigen test, which is much more sensitive and specific. Although still taught and occasionally used in resource-limited settings.

Description: India Ink prep 

Blue arrow pointing to capsule. Red arrow pointing to a budding yeast cell

Magnification: 40X

Specimen Source: CSF

Date Taken: 7.1.2015

NOTES:

1.  The India ink prep is most commonly performed on cerebrospinal fluid (CSF).

2.  A positive India ink preparation strongly suggests infection with Cryptococcus neoformans. Some laboratories will not report as positive unless budding yeast cells are seen.

3. The presence of encapsulated buds, smaller than the mother cell is diagnostic of Cryptococcus neoformans.

4. Standard practice when performing an India ink prep is also to do a Gram stain of the CSF .  

Gram staining can be problematic for capsulated Cryptococcus neoformans yeast cells because of their thick polysaccharide capsule. Crytococcus is generally considered Gram-positive but the cells may stain Gram-variable or appear faint. This issue can make it difficult to distinguish yeast cells from artifacts. See Gram stain gallery below.

The photo gallery below shows photomicrographs of India ink preps of CSF specimens at 10x, 40x and 100x magnification

The photo gallery below shows photomicrographs of gram stains of CSF specimens at 10x, 40x and 100x magnification