A new clinical practice guideline from the American Thoracic Society (ATS) emphasizes the need for rapid diagnosis of fungal infections through the use of newer lab tests.
Based on a systematic review of the scientific literature, the guideline covers lab tests for diagnosing invasive pulmonary aspergillosis, invasive candidiasis, histoplasmosis, blastomycosis, and coccidioidomycosis, among other infections. Options reviewed include the following:
- Antigen testing in urine
- Blood and bronchoalveolar lavage fluid
- Nucleic acid-based polymerase chain reaction (PCR) assays
"Effective treatment of patients with these infections depends on rapid, accurate diagnosis of the infection and on timely treatment," the ATS said in a statement. "Delays in diagnosis and treatment can be debilitating, leading to long hospital stays, high medical costs and even, death."
Key recommendations, based on what the ATS views as high-quality evidence, include the following:
- Serum galactomannan testing is recommended for patients who are severely immunocompromised.
- Blood or serum PCR testing should be done for Aspergillus.
- The histoplasma antigen in urine or serum should be used for suspected disseminated and acute pulmonary histoplasmosis in cases that require fast diagnosis and treatment.