Current Algorithms in Fungal Diagnosis in the Immunocompromised Host

  • Thomas LehrnbecherEmail author
  • Karsten Becker
  • Andreas H. Groll
Part of the Methods in Molecular Biology book series (MIMB, volume 1508)


Invasive fungal diseases (IFDs) are a major cause of morbidity and mortality in immunocompromised patients such as patients with hematological malignancies or allogeneic hematopoietic stem cell transplant recipients. Whereas the definite diagnosis of IFD requires invasive diagnostic procedures, imaging and noninvasive diagnostic assays may help in decision making with regard to the institution and the choice of antifungal agents, the duration of therapy, surgical intervention, and monitoring of fungal manifestations.

Unfortunately, signs and symptoms of IFD are often nonspecific in the immunocompromised patient. Therefore, in immunocompromised patients with suspected IFD, all samples collected need to be cultured for fungi, and, in the case of specimens obtained by invasive diagnostic procedures, also microscopically examined. For high sensitivity of the cultural and microscopic approaches, specific media and stains, respectively, are crucial. Non-culture based method such as the detection of galactomannan or ß-d-glucan and molecular tools such as polymerase chain reaction may help in the early diagnosis of IFD. Imaging studies may be indicative for IFD, but invasive diagnostics such as bronchoalveolar lavage and/or biopsy should be pursued in order to identify the causative pathogen. This chapter summarizes the current knowledge on diagnosing IFD and proposes practical help in the use of diagnostic tools.

Key words

Invasive fungal disease Culture Galactomannan ß-d-glucan Polymerase chain reaction Computerized tomography Magnetic resonance imaging Brochoalveolar lavage Biopsy 


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Thomas Lehrnbecher
    • 1
    Email author
  • Karsten Becker
    • 2
  • Andreas H. Groll
    • 3
  1. 1.Pediatric Hematology and Oncology, Hospital for Children and AdolescentsJohann Wolfgang Goethe-UniversityFrankfurtGermany
  2. 2.Institute of Medical MicrobiologyUniversity Hospital MünsterMünsterGermany
  3. 3.Department of Pediatric Hematology/Oncology, Infectious Disease Research Program, Center for Bone Marrow TransplantationUniversity Children’s Hospital MünsterMünsterGermany

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