Mycology

Abstract

Fungal infections/mycoses are an important cause of morbidity and mortality, especially in patients with an impaired immune system. The clinical diagnosis relies mainly on conventional methods like direct microscopy, culture, radiographic imaging and the evaluation of clinical symptoms. Identification of the fungal pathogen is possible when a positive culture is available, but the diagnostic sensitivity of fungal culture is very low. Molecular assays have been developed to aid in the identification of the fungi when cultures remain negative. These assays can be used to identify the fungi when fungal elements are seen in clinical material. Recently, the more sensitive genus- and species-specific qPCR assays are increasingly being used to aid in the rapid diagnosis of fungal infections. Many PCR assays for the direct detection and identification of dermatophytes in clinical material have been developed during the last decade. The introduction of real-time PCR assays in routine clinical laboratories has speeded up dermatophytosis diagnostics tremendously from turnaround times of two to four weeks (culture), to less than one day. It has also resulted in a huge reduction in hands-on time. Another major advantage of (real-time) PCR is the superior sensitivity as compared to dermatophyte culture. The development of molecular diagnostics has greatly improved the possibilities for faster, more guided treatment of dermatologic disorders, resulting in a significant decrease of adverse effects of antifungals.