title: British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases.
abstract: Invasive fungal diseases are an important cause of morbidity and mortality in a wide range of patients, and early diagnosis and management are a challenge. We therefore did a review of the scientific literature to generate a series of key recommendations for the appropriate use of microbiological, histological, and radiological diagnostic methods for diagnosis of invasive fungal diseases. The recommendations emphasise the role of microscopy in rapid diagnosis and identification of clinically significant isolates to species level, and the need for susceptibility testing of all Aspergillus spp, if treatment is to be given. In this Review, we provide information to improve understanding of the importance of antigen detection for cryptococcal disease and invasive aspergillosis, the use of molecular (PCR) diagnostics for aspergillosis, and the crucial role of antibody detection for chronic and allergic aspergillosis. Furthermore, we consider the importance of histopathology reporting with a panel of special stains, and emphasise the need for urgent (<48 hours) and optimised imaging for patients with suspected invasive fungal infection. All 43 recommendations are auditable and should be used to ensure best diagnostic practice and improved outcomes for patients.
authors.affiliation: Department of Microbiology, Royal Brompton Hospital, London, UK. Electronic address: sschelenz@doctors.org.uk.
authors.forename: Silke
authors.initials: S
authors.lastname: Schelenz
authors.affiliation: Department of Microbiology, University Hospital, Cardiff, UK.
authors.forename: Rosemary A
authors.initials: RA
authors.lastname: Barnes
authors.affiliation: Mycology Reference Centre, Leeds General Infirmary, Leeds, UK.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Barton
authors.affiliation: Department of Radiology, Royal Free Hospital, London, UK.
authors.forename: Joanne R
authors.initials: JR
authors.lastname: Cleverley
authors.affiliation: Department of Histopathology, St Thomas's Hospital, London, UK.
authors.forename: Sebastian B
authors.initials: SB
authors.lastname: Lucas
authors.affiliation: Centre for Medical Microbiology, University College London, London, UK.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Kibbler
authors.affiliation: National Aspergillosis Centre, University Hospital of South Manchester and University of Manchester, Manchester, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
mesh_terms: D019411:Clinical Laboratory Techniques / Q000379:methods*; D042241:Early Diagnosis; D006801:Humans; D009181:Mycoses / Q000175:diagnosis*; D010336:Pathology / Q000379:methods*; D011871:Radiology / Q000379:methods*; D006113:United Kingdom