Update on Fungal Diagnostics

Invasive fungal disease (IFD) is becoming more prevalent in transplant and oncology patients as a result of the potent immunosuppressive therapies used to prevent allograft rejection and/or the use of cytotoxic chemotherapy to treat cancer. Mortality attributable to IFD remains high despite advances in antifungal therapies. There is a continued need for laboratory diagnostics to help improve clinical outcomes. In recent years, culture-based detection strategies and histopathology have been supplemented with molecular and proteomic techniques as well as antigen detection methods. Refinements in these assays are improving the diagnosis of IFD, with the greatest strides made within the molecular and proteomic arenas. This review highlights recent laboratory developments in the diagnosis of invasive candidiasis, cryptococcosis, opportunistic molds, and endemic fungal infections.