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Volume 39, Number 3, June 2006

Invasive fungal infection — laboratory diagnosis and antifungal treatment


Pei-Lan Shao, Li-Min Huang, Po-Ren Hsueh
Departments of Laboratory Medicine, Pediatrics and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

Received: February 1, 2006       Accepted: February 15, 2006   

 

Corresponding author:

Dr. Po-Ren Hsueh, Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, No 7, Chung-Shan South Road, Taipei, Taiwan. E-mail: hsporen@ha.mc.ntu.edu.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Methods:

Invasive fungal infections (IFIs) have become increasingly prevalent in the recent decade along with the increasing populations of immunocompromised patients and widespread use of the broad-spectrum antibiotics. The morbidity and the mortality of IFIs remain high while the diagnosis and treatment of IFIs are highly challenging. Recent advances in diagnostic methods and antifungal agents provide the potential to improve the outcomes of these infections. Conventional diagnostic methods including microbiological cultures and histopathological diagnosis have the disadvantages of either insensitivity or requiring invasive procedures. The innovative techniques of detecting circulating fungal antigens and detecting fungal genomic DNA represent improvements in the diagnosis of invasive aspergillosis. Several antifungal agents have been developed in recent years, such as lipid formulations of amphotericin B, newer azoles, and echinocandins. These agents have either lower toxicities or greater activities against certain fungi compared with older treatments. With the availability of diverse antifungal agents, their use in combination has the potential to produce additive or synergistic effects, leading to better treatment outcomes. Large-scale randomized clinical trials are needed to confirm the efficacy of combination strategies.

 



 

Key words:

Antifungal agents, diagnosis, laboratory techniques and procedures, mycoses, review



 



 

J Microbiol Immunol Infect 2006;39:178-188.