Diagnosis

DIAGNOSING FUNGAL INFECTIONS

A small number of fungal infections are so distinctive that the diagnosis can be made without any additional testing, although confirmation may be desirable. In most cases there are alternative plausible diagnoses possible, and sometimes a fungal infection co-exists with another infection or other diagnosis.

In addition to making or confirming the diagnosis of fungal infection, full mycological testing has several advantages:

  • Knowing which fungus is involved guides appropriate antifungal choice, dose and duration of therapy. It may also guide investigations seeking the source of infection.
  • Additional or dual infections can be identified (i.e. 3-5% of Candida bloodstream infections).
  • The severity of infection may be revealed from the extent of involvement on skin or scans, the number or load of organisms visible on microscopy or histology or the strength of signal on antigen or PCR tests. These factors may assist in determining whether additional therapy should be added and in following response to therapy.
  • Assessing whether antifungal resistance is present, and so an alternative antifungal agent is required.

Some samples are easy to take and process, blood and urine being the obvious examples. Others are harder, including fingernail or toenail clippings, tissue biopsies and respiratory samples. Additional guidance may be required beyond what is given on this website.

NOTE: A full version of this information that includes other fungi is available at Life-Worldwide

OTHER RESOURCES: The European Confederation for Medical Mycology (ECMM) is constructing a database of diagnostic techniques for fungal infections.



Collected diagnostics reference papers




Displaying 1 - 30 of 30
Guidelines
Year
Diagnosis of aspergillosis by PCR: Clinical considerations and technical tips 2017
EUCAST proposes to change the definition and usefulness of the susceptibility category ‘Intermediate’ 2017
Technical Aspects and Applications for Developing in situ Hybridization Procedures for Formalin-Fixed and Paraffin-Embedded (FFPE) Tissues for Diagnosis of Fungal Infections 2017
Effect of involved Aspergillus species on galactomannan in bronchoalveolar lavage of patients with invasive aspergillosis 2017
The Chinese guidelines for the diagnosis and treatment of invasive fungal disease in patients with hematological disorders and cancers (the fifth revision). 2017
Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update. 2017
Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management 2016
Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. 2016
Characterization of patients with chronic pulmonary aspergillosis according to the new ESCMID/ERS/ECMM and IDSA guidelines. 2016
The 2015 International Society for Heart and Lung Transplantation Guidelines for the management of fungal infections in mechanical circulatory support and cardiothoracic organ transplant recipients: Executive summary. 2016
British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases 2015
MRI of CNS fungal infections: review of aspergillosis to histoplasmosis and everything in between. 2014
Histopathologic diagnosis of fungal infections in the 21st century 2011
Antigen detection in the diagnosis of Invasive Aspergillosis 2008
Antifungal susceptibility testing in Aspergillus spp. according to EUCAST methodology. 2006
Aspergillosis & Other Filamentous Fungi: Shortcomings of the Old…& Solutions in the New Edition! 2005
Endemic mycoses in immune compromised patients 2005
British Society for Medical Mycology proposed standards of care for patients with invasive fungal infections 2003
Criteria for enrollment: Randomized comparison of Voriconazole and Amphotericin B in primary therapy of invasive aspergillosis 2001
Definitions
Year
Performance of 1,3-β-D-glucan for diagnosing invasive fungal diseases in children 2017
Chest CT scans are frequently abnormal in asymptomatic patients with newly diagnosed acute myeloid leukemia. 2016
Revised Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) C 2008
Public Consultation Document: EORTC/BAMSG Consensus Revised definitions draft VI Proven invasive fungal diseases Deep tissue disease Moulds 2005
EORTC revised definitions II. Why revise? Process and Definitions 2005
Published rather than Proposed Definitions for Invasive Fungal Infection Must Be Applied to Allow Standardization in Clinical Trials 2004
Allergic bronchopulmonary aspergillosis in cystic fibrosis - state of the art: Cystic Fibrosis Foundation Consensus Conference 2003
Analysis of Definitions Used In Clinical Research on Invasive Fungal Infections (IFI): Consensus Proposal for New, Standardized Definitions. 2003
Defining Opportunistic Invasive Fungal Infections in Immunocompromised Patients with Cancer and Hematopoietic Stem Cell Transplants: An International Consensus 2002
Year
Fungal diagnostics 2014
Fungal diagnostics: review of commercially available methods 2013