Thick, discolored nails? Find the real cause.
A molecular nail panel that identifies 24 fungal, bacterial and parasitic pathogens from nail clippings — so treatment matches the organism instead of a guess.
- $199 flat · results in 24–48 hours
- 24 pathogens: fungi, bacteria and a parasite
- No appointment, no insurance claim
Panel
24 pathogens
Sample
Nail clippings or shavings
Results
24–48 hours at the lab
Price
$199 flat
What we test for
24 fungal, bacterial & parasitic pathogens.
Every target is detected and quantified with real-time PCR, so organisms that are slow-growing or difficult to culture still show up.
Dermatophyte fungi
Trichophyton interdigitale (T. mentagrophytes), T. rubrum, T. soudanense / violaceum, Epidermophyton floccosum and Microsporum species.
Candida yeasts
Candida albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis, C. dubliniensis and C. lusitaniae.
Molds & other fungi
Aspergillus species (A. fumigatus, A. niger, A. terreus, A. versicolor), Acremonium strictum, Alternaria species, Curvularia lunata, Fusarium solani, Microsporum species, Neofusicoccum mangiferae, Pichia onychis, Scopulariopsis brevicaulis and Trichosporon species.
Bacteria
Pseudomonas aeruginosa and Staphylococcus aureus — bacterial causes of nail discoloration that antifungal treatment will not fix.
Parasite
Sarcoptes scabiei, the mite behind scabies, which can involve the nails in crusted scabies.
The science
Nail disease is more often mixed than purely fungal.
About half of abnormal-appearing nails actually involve onychomycosis — a fungal infection of the nail plate — but the rest trace to bacteria, yeasts, molds, psoriasis or trauma. Dermatophytes invade the keratin of the nail, while Candida and gram-negative bacteria such as Pseudomonas produce their own characteristic discoloration. Because the treatments differ, the organism has to be identified before therapy starts; molecular PCR detects fungal, bacterial and parasitic DNA directly from clippings, without waiting weeks for a culture.
~50%
of abnormal-appearing nails are estimated to involve onychomycosis — making it the most common nail disorder seen in dermatology.
Source: Gupta et al., Journal of Dermatological Treatment
~50–60%
of positive fungal cultures identify a specific organism; fungal culture fails or misses the organism in a substantial share of infected nails.
Source: Dermatophyte culture sensitivity estimates, clinical mycology literature
12 weeks
is the typical minimum course of oral antifungal therapy for toenail onychomycosis — reason enough to confirm the organism first.
Source: AAD/clinical treatment guidance
~80%
of onychomycosis cases are caused by dermatophyte fungi, most often Trichophyton rubrum; the remainder split between yeasts and non-dermatophyte molds.
Source: Westermann et al., J Eur Acad Dermatol Venereol
How often does testing make sense?
Test whenever a nail is thickened, discolored or crumbling and treatment decisions are being made — especially before committing to a 12-week oral antifungal course. Confirm the organism first if a previous antifungal failed, more than one nail is involved, or the appearance changed after treatment. Re-test after therapy only if the nail does not clear as expected.
References
- Gupta AK, Versteeg SG, Shear NH. Onychomycosis in the 21st century: an update on diagnosis, epidemiology, and treatment. Journal of Cutaneous Medicine and Surgery. 2017;21(6):525–539.
- Westermann GJM, Geerts LG, Goedhart HA, Stoot JEM, Guldemond NA. Improving antifungal treatment of onychomycosis. J Eur Acad Dermatol Venereol. 2004;18(2):199–202.
- Elewski BE. Onychomycosis: treatment, quality of life, and economic considerations. American Journal of Clinical Dermatology. 2000;1(1):19–26.
- CDC. Fungal nail infections (onychomycosis) — clinical overview.
From the lab
Test specifications at a glance
How each molecular panel runs at our CLIA-certified, CAP-accredited laboratory in Germantown, Maryland.
Urinary Tract Infection Panel
- Method
- Quantitative real-time PCR for pathogen detection, quantification, and resistance gene identification
- Preferred specimen
- Urine
- Panel coverage
- 14 urinary tract pathogens plus 9 antibiotic resistance markers
- Turnaround
- 24 hours (typical)
Designed to detect organisms that are slow-growing or difficult to culture.
Vaginal Microbiota Panel
- Method
- Quantitative real-time PCR for pathogen detection, quantification, and resistance gene identification
- Preferred specimen
- Vaginal swab
- Panel coverage
- 37 molecular pathogens associated with bacterial vaginosis, urinary tract infections, vaginitis, and STIs
- Turnaround
- 24 hours (typical)
- Resistance genes
- Available as an option
Reports protective and disruptive flora alike — Lactobacillus species, Gardnerella vaginalis, Atopobium vaginae, Mobiluncus, and Megasphaera — to place your microbiome in context.
STI Panel
- Method
- Quantitative real-time PCR (qPCR) for highly sensitive pathogen detection and quantification
- Preferred specimen
- Vaginal swab or urine
- Panel coverage
- 14 clinically relevant bacterial and viral pathogens
- Turnaround
- 24 hours (typical)
- Resistance genes
- Available as an option
Designed for both male and female patients. HPV types 16, 18, and 45 are reported for women over 31.
Wound Infection Panel
- Method
- Quantitative real-time PCR for pathogen detection, quantification, and resistance gene identification
- Preferred specimen
- Wound swab or skin swab
- Panel coverage
- 15 molecular pathogens plus 9 antibiotic resistance markers
- Turnaround
- 24 hours (typical)
Designed to detect organisms that are slow-growing or difficult to culture.
Nail Infection Panel
- Method
- Quantitative real-time PCR for pathogen detection, quantification, and resistance gene identification
- Preferred specimen
- Nail clipping or shavings
- Panel coverage
- 24 molecular pathogens across bacteria, fungi, and parasites
- Turnaround
- 24 hours (typical)
- Resistance genes
- Available as an option
Covers dermatophytes (Trichophyton, Microsporum, Epidermophyton), Candida species, molds such as Aspergillus and Fusarium, plus bacteria and the scabies mite (Sarcoptes scabiei).
Respiratory Pathogen Panel
- Method
- Quantitative real-time PCR for pathogen detection, quantification, and resistance gene identification
- Preferred specimen
- Nasal swab
- Panel coverage
- 32 molecular pathogens — 8 bacterial and 24 viral
- Turnaround
- 24 hours (typical)
- Resistance genes
- Available as an option
Covers influenza A and B, RSV A and B, four common human coronaviruses, parainfluenza 1–3, human metapneumovirus, and more.
Gastrointestinal Pathogen Panel
- Method
- Quantitative real-time PCR for pathogen detection, quantification, and resistance gene identification
- Preferred specimen
- Stool swab
- Panel coverage
- 26 molecular pathogens — 13 bacterial and 13 viral and protozoal
- Turnaround
- 24 hours (typical)
- Resistance genes
- Available as an option
Includes C. difficile toxin A/B, Shiga toxin-producing E. coli (stx1/stx2), Campylobacter, Salmonella, Shigella, norovirus GI/GII, and Giardia.
Who this is for
Nail changes that look alike can have very different causes — and very different treatments.
A thickened or crumbling nail
Changes that have lasted for months or keep coming back.
Treatment that did not work
An antifungal course that did not clear it — the organism may not be a fungus.
Not sure what it is
Know whether it is fungal, bacterial or something else before treating.
Sent by a podiatrist
Your clinician asked for laboratory confirmation before starting treatment.
Should you test now?
A nail that is thickened, crumbly, discolored or lifting.
Nail changes that have lasted for months or keep coming back.
An antifungal treatment that did not clear it.
You want to know whether it is fungal, bacterial or something else before treating.
A podiatrist or clinician asked you to test.
You want results without waiting for an appointment.
If any of these sound familiar, testing is the fastest way to get an answer.
Before you order
Total price
$199
One-time flat price, paid directly to the lab. No separate fee for the kit, return shipping or the healthcare provider order.
What's included
Kit to report
Collection kit and instructions, a prepaid FedEx overnight return label, the healthcare provider order, real-time PCR analysis in our lab and a secure online report.
Who orders the test
A licensed healthcare provider
A licensed healthcare provider in our network reviews your request and places the order during checkout, at no extra cost. No referral needed.
When to expect results
24–48 hours
After the lab receives your sample. Samples dropped off before 11am are processed the same day.
Questions people actually ask
Get my test — $199.
Kits ship to your door, or drop your sample off at our Maryland lab. Same-day processing for samples dropped off before 11am.