Invasive fungal infection--laboratory diagnosis and antifungal treatment.
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.
Shao
Pei Lan
PL
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Huang
Li Min
LM
Hsueh
Po Ren
PR
D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D005658:Fungi / Q000254:growth & development*; D006801:Humans; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy*
D000935:Antifungal Agents