Abstract
In this review, we discuss the old and new tools available to the clinical mycology laboratory, the “growing pains” in their use, and how they impact patient care and aim to recommend what clinical mycology laboratories need to do to succeed in optimizing patient care. Through the years, studies have shown the importance of the radiologic, molecular, and non-molecular methods for the diagnosis and follow-up of patients with invasive fungal infections (IFIs) and their impact on patient outcome. (1) Accurate fungal species identification is essential. (2) Histopathology can be insightful, and the clinical mycology laboratory needs to collaborate with the pathology department for optimization of care. (3) Rapid diagnosis is important and biomarkers need to carefully replace or reduce spiraling antifungal empiricism. (4) Culture techniques need to be carefully integrated with rapid diagnostic methods. (5) IFIs are deadly but a combination of a receptive and progressive mycology laboratory and a small cadre of antifungal agents can save lives. (6) The clinical mycology laboratory needs to be carefully linked to clinical practices, antifungal stewardship, and infection control challenges.
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