Update on the Laboratory Diagnosis

Recent advances in the management of patients with haematological malignancies and transplant recipients have paralleled an increase in the incidence of fungal diseases due to pathogenic genera such as Candida including Fusarium and Zygomycetes opportunistic infections have high mortality. Rapid and reliable species identification is essential for antifungal treatment, but detection of the increasing conventional phenotypic methods remains difficult and time sometimes be inconclusive, especially for unusual species. New diagnostic techniques (e.g., 1,3 d-glucan detection) could improve this scenario, although further studies are necessary to confirm their usefulness in clinical practice. Introduction: Despite the development of new techniques and new antifungal agents, diagnosis of invasive fungal infection (IFI), which still relies upon a combination of clinical observation and laboratory investigation, remains a challenge especially for immunocompromised patients with haematological disease. 1 This has important clinical repercussions since delayed diagnosis and therapy contribute significantly to the high mortality rates associated with IFIs, 2 whereas early intervention with antifungal drugs may result in more effective management of high patients. 3 While superficial and subcutaneous fungal infections often produce characteristic lesions that suggest the diagnosis, a thorough knowledge of www.mjhid.org ISSN 2035-3006 of Invasive Fungal Infections. 1 , Patrizia Posteraro 2 and Maurizio Sanguinetti -00168, Rome, Italy. -IDI IRCSS, via -06-3015-152. E-mail: msanguinetti@rm.unicatt.it at no competing interests exist. , DOI 10.4084/MJHID.2011.002 mits unrestricted use, distribution, and reproduction in any medium, and Aspergillus and the emergence of less comm . Despite availability of new antifungal agents these diversity of fungal pathogens by -consuming, and the results may -risk potential causative organisms is yet required to aid the diagnostic process, mainly in situations where systemic fungal infection is suspected but the clinical presentation is nonspecific and then ascribable to a wide range of infections, underlying illnesses, or complication of treatments. 4 The exact identification of the infecting organism is became essential in light of the increased use of prophylactic schedules that predispose the patient not just to fungal infection, but also to the selection of fungal species such as non-albicans glabrata and C. krusei), Aspergillus Scedosporium species, and Zygomycetes 1