Advances in diagnosis approaches of invasive fungal infections inhaematological malignancy patients

Background and Aim : Invasive fungal infections (IFI) remain important causes of morbidity andmortality in hematologic malignancy patient’s population. It is clear that new approaches to themanagement of IFIs are required. Recent advances in diagnosis now allow the use of very sensitiveimaging techniques with an extremely low negative predictive value. New diagnostic methodsfacilitate an early diagnosis of invasive fungal disease and allow for utilization of a pre-emptivetreatment approach, which may ultimately lead to improved treatment outcomes and reducedtoxicity.Methods : The aim of this article is to review classical and new diagnostic tools for IFIs inhematologic malignancy patient’s and to summarize current limitations of these methods.Results : Since conventional diagnostic tools such as culture lack sensitivity and specificity,alternative diagnostic assays have been developed. In recent years, progress has been made in thedevelopment and evaluation of sensitive sero-diagnostic assays, including detection of genomicDNA sequences and fungal antigens, which aid in a rapid, early diagnosis of IFI. Both serologyand PCR can be used to monitor the response to antifungal therapy. The optimal use of non-culturebasedmethods is in prospective screening of patients at high risk.Conclusion : The early diagnosis of IFIs still remains a problem as existing tools lack sensitivityor specificity. Therefore, the combination of microscopy, culture-based methods, and serologicaland molecular techniques is necessary to allow early detection of IFIs.

کلیدواژه ها:

Invasive fungal infections ، new approaches ، haematological malignancy