Thoracic guideline advises newer tests for fungal infections

2019 08 30 20 54 9805 Aspergillus Fungus Lung 400

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.