title: Detection and investigation of invasive mould disease.
abstract: A comprehensive review of diagnostic techniques for opportunistic systemic mycoses focused on invasive mould disease in immunocompromised patients is presented. We first analysed conventional diagnostic methods, such as microscopy examination, culture and radiology, underlining their limitations, which have led to the development of alternative methods, such as the detection of fungal components. Among these we highlight fungal antigen and DNA quantification, which make it possible to detect infections early and start appropriate treatment. We also briefly review the methods for carrying out susceptibility tests for antifungal drugs, including reference procedures, commercial techniques and their indications. Furthermore, we analyse the recommendations for therapeutic drug monitoring of antifungal agents in body fluids.
authors.affiliation: Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain. mcuenca-estrella@isciii.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Cuenca-Estrella
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Cornelia
authors.initials: C
authors.lastname: Lass-Flörl
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rácil
authors.forename: Malcolm
authors.initials: M
authors.lastname: Richardson
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Rogers
mesh_terms: D000946:Antigens, Fungal / Q000032:analysis; D019411:Clinical Laboratory Techniques / Q000379:methods*; D004271:DNA, Fungal / Q000032:analysis; D016903:Drug Monitoring / Q000379:methods; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D008826:Microbial Sensitivity Tests / Q000379:methods; D009172:Mycology / Q000379:methods*; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000382:microbiology*
chemical_list: D000946:Antigens, Fungal; D004271:DNA, Fungal