Abstract
The frequency of fungal infections, especially of Invasive Fungal Infections (IFIs), has risen dramatically in recent years, and has high morbidity and mortality. Early and accurate diagnosis is important for timely implementation of antifungal therapy and decreasing the unnecessary use of toxic antifungal agents. Conventional microbiological, histological and radiological techniques remain the cornerstone of diagnosis but are insensitive and have a limited impact on clinical decision-making. There is always a need to characterize fungi quickly and accurately which can be done by rapid diagnostic techniques like antigen detection and molecular techniques. This is a brief review of all the microbiological techniques- conventional and recent alternative techniques especially elaborating antigen detection and molecular techniques which are available for diagnosis of fungal infections.
Highlights
The fungi are saprophytic and parasitic eukaryotic organisms
The frequency of fungal infections, especially of Invasive Fungal Infections (IFIs), has risen dramatically in recent years due to Prolonged antibiotic therapy esp Candida spp and Aspergillus AIDS esp Candida, Cryptococcus, Aspergillus, Histoplasma Corticosteroid and cytotoxic chemotherapy esp Candida and Aspergillus I/V catheters and surgery Candida, Aspergillus and Zygomycetes Opportunistic IFIs remain an important cause of morbidity and mortality
Invasive fungal infections constitute a major challenge for the management of immunocompromised patients, mainly haematooncology patients, transplant etc
Summary
The fungi are saprophytic and parasitic eukaryotic organisms. Historically, the fungi were regarded as relatively insignificant causes of infection. Standard approaches to the laboratory diagnosis of IFIs include direct microscopic examination in freshly obtained samples, histopathological demonstration of fungi within tissue sections, culture of the causative fungus and its further identification. These approaches are often not sufficiently sensitive and/or specific to diagnose IFIs, and they sometimes require invasive procedures to obtain the necessary specimens and culture takes 2-4 wks to become positive. There is need for rapid methods which are sensitive and specific for diagnosis of fungal infections [1,2] This is a brief review of all the microbiological techniquesconventional and recent alternative techniques especially elaborating. Diagnostic Methods for Fungal Infections Direct examination – wet mount, HPE, flourescent staining Fungal culture Radiology Non culture methods: a) Serological methods- antigen detection, antibody detection b) Tests for detection of metabolites c) Tests for detection of CMI (cell mediated immunity) d) Molecular methods e) Others- MALDI-TOF MS
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