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Review
. 2020 Jul;14(7):703-714.
doi: 10.1080/17476348.2020.1753506. Epub 2020 Apr 21.

Advances in the diagnosis of fungal pneumonias

Bryan T Kelly  1 , Kelly M Pennington  1   2 , Andrew H Limper  1   2
Affiliations
Review

Advances in the diagnosis of fungal pneumonias

Bryan T Kelly et al. Expert Rev Respir Med. 2020 Jul.

Abstract

Introduction: Fungal infections are increasingly encountered in clinical practice due to more favorable environmental conditions and increasing prevalence of immunocompromised individuals. The diagnostic approach for many fungal pathogens continues to evolve. Herein, we outline available diagnostic tests for the most common fungal infections with a focus on recent advances and future directions.

Areas covered: We discuss the diagnostic testing methods for angioinvasive molds (Aspergillus spp. and Mucor spp.), invasive yeast (Candida spp. and Cryptococcus ssp.), Pneumocystis, and endemic fungi (Blastomyces sp., Coccidioides ssp., and Histoplasma sp.). The PubMed-NCBI database was searched within the past 5 years to identify the most recent available literature with dates extended in cases where literature was sparse. Diagnostic guidelines were utilized when available with references reviewed.

Expert opinion: Historically, culture and/or direct visualization of fungal organisms were required for diagnosis of infection. Significant limitations included ability to collect specimens and delayed diagnosis associated with waiting for culture results. Antigen and antibody testing have made great strides in allowing quicker diagnosis of fungal infections but can be limited by low sensitivity/specificity, cross-reactivity with other fungi, and test availability. Molecular methods have a rich history in some fungal diseases, while others continue to be developed.

Keywords: Aspergillus; Blastomyces; Candida; Coccidioides; Cryptococcus; Histoplasma; Mucor; Pneumocystis.

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Conflict of interest statement

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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