Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice: An official American thoracic society clinical practice guideline

on behalf of the American Thoracic Society Assembly on Pulmonary Infections and Tuberculosis

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

Background: Fungal infections are of increasing incidence and importance in immunocompromised and immunocompetent patients. Timely diagnosis relies on appropriate use of laboratory testing in susceptible patients. Methods: The relevant literature related to diagnosis of invasive pulmonary aspergillosis, invasive candidiasis, and the common endemic mycoses was systematically reviewed. Meta-analysis was performed when appropriate. Recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: This guideline includes specific recommendations on the use of galactomannan testing in serum and BAL and for the diagnosis of invasive pulmonary aspergillosis, the role of PCR in the diagnosis of invasive pulmonary aspergillosis, the role of b-D-glucan assays in the diagnosis of invasive candidiasis, and the application of serology and antigen testing in the diagnosis of the endemic mycoses. Conclusions: Rapid, accurate diagnosis of fungal infections relies on appropriate application of laboratory testing, including antigen testing, serological testing, and PCR-based assays.

Original languageEnglish (US)
Pages (from-to)535-550
Number of pages16
JournalAmerican journal of respiratory and critical care medicine
Volume200
Issue number5
DOIs
StatePublished - Sep 1 2019

Keywords

  • Antigen testing
  • Fungal diagnosis
  • PCR
  • Serology

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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