Deanne Knutson, Anatomic Pathology Supervisor, St. Alexius Medical
Center, Bismarck, North Dakota asks:

>>We use Chromium Trioxide in our GMS stain, and the cost has escalated 
>>tremendously. Does anyone use a substitute for this chemical?  I am curious 
>>what others are using for their GMS stain. We still do our stains manually at 
>>the present time.<<

There is no completely satisfactory substitute for chromium trioxide
(chromic acid) for the oxidation step for the GMS stain for fungi,
particularly if you're trying to stain Histoplasma. Many kits
substitute periodic acid, usually in inadequate amounts. Freida Carson
published a careful study of this problem several years ago and
concluded that periodic acid could be substituted, with sufficient
time and temperature. (I think I can find this reference, but it's
probably already in our archives.) Last time I looked (2006) the
Ventana method still used chromium trioxide.

Bob Richmond
Samurai Pathologist
Knoxville TN

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