title: Preemptive antifungal therapy: still a way to go.
abstract: OBJECTIVE
  Early treatment of invasive mold infections improves the outcome. Therapy is often delayed, however, because available diagnostic tools such as culture, microscopy and conventional radiology lack sensitivity; consequently, empirical initiation of antifungal therapy has been advocated, particularly for patients with prolonged unexplained neutropenic fever.
  
  
  RESULTS
  Much recent progress has been made in the development and evaluation of nonculture-based assays, including the detection of the fungal antigens galactomannan and beta-D-glucan and the detection of fungal DNA by polymerase chain reaction techniques. These new tools should aid the rapid, early diagnosis of invasive fungal disease, especially when used as screening tools in conjunction with sensitive imaging techniques.
  
  
  CONCLUSIONS
  The review will consider these recent developments with the purpose of introducing the concept of preemptive antifungal therapy.
authors.affiliation: Department of Hematology, Acute Leukemia and Stem Cell Transplantation Unit, University Hospital Gasthuisberg, Leuven, Belgium. johan.maertens@uz.kuleuven.ac.be
authors.forename: Johan
authors.initials: J
authors.lastname: Maertens
authors.forename: Dries
authors.initials: D
authors.lastname: Deeren
authors.forename: Daan
authors.initials: D
authors.lastname: Dierickx
authors.forename: Koen
authors.initials: K
authors.lastname: Theunissen
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D000946:Antigens, Fungal / Q000032:analysis; D004271:DNA, Fungal / Q000032:analysis; D003952:Diagnostic Imaging; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D008351:Mannans / Q000032:analysis; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D011509:Proteoglycans; D047071:beta-Glucans / Q000032:analysis
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D004271:DNA, Fungal; D008351:Mannans; D011509:Proteoglycans; D047071:beta-Glucans; C012990:galactomannan; C010770:polysaccharide-K; D005690:Galactose