Skip to main content
Top
Published in: Current Fungal Infection Reports 1/2018

01-03-2018 | Clinical Pathology (C Sundaram, Section Editor)

Challenges in the Diagnosis of Invasive Fungal Infections in Immunocompromised Hosts

Authors: Spinello Antinori, Mario Corbellino, Carlo Parravicini

Published in: Current Fungal Infection Reports | Issue 1/2018

Login to get access

Abstract

Purpose of review

The expanding population of immunocompromised patients coupled with the recognition of a growing number of different species of fungi responsible for diseases in such hosts makes the diagnosis of invasive fungal infection (IFI) a challenging task. The recent advances and challenges in the diagnosis of IFI in the setting of immunocompromised hosts are reviewed. The advantages and limitations of histopathology and the role of culture-independent methods, such as those based on the use of nucleic acids applied to fresh and formalin-fixed, paraffin-embedded sections, besides culture- and non-culture-based diagnostic methods, to obtain a timely and correct diagnosis of IFI are highlighted.

Recent findings

The therapeutic implications of identifying the genus and species of the fungus present in the specimen with the molecular diagnostics applied to tissue specimens are reviewed. No method alone is efficient in correctly identifying fungi and it is essential to combine the traditional histochemical staining with molecular methods to achieve a rapid and genus-/species-specific diagnosis of IFI.

Summary

We review the recent findings and challenges in the hystopathologic diagnosis of IFI in the setting of immunocompromised hosts. Non method alone is efficient in correctly identify fungi and pathologists should combine classic staining with molecular methods to achieve a rapid and genus/species fungal diagnosis.
Literature
21.
go back to reference • Salehi E, Hedayati MT, Zoll J, Rafati H, Ghasemi M, Doroudinia A, et al. Discrimination of aspergillosis, mucormycosis, fusariosis, and scedosporiosis in formalin-fixed paraffin-embedded tissue specimens by use of multiple real-time quantitative PCR assays. J Clin Microbiol. 2016;14:2798–803. https://doi.org/10.1128/JCM.01185-16. A multicenter study regarding the use of multiple real-time quantitative PCR assays of formalin-fixed paraffin-embedded tissue specimens to identify Aspergillus , Fusarium , Scedosporium , and Mucormycetes. CrossRef • Salehi E, Hedayati MT, Zoll J, Rafati H, Ghasemi M, Doroudinia A, et al. Discrimination of aspergillosis, mucormycosis, fusariosis, and scedosporiosis in formalin-fixed paraffin-embedded tissue specimens by use of multiple real-time quantitative PCR assays. J Clin Microbiol. 2016;14:2798–803. https://​doi.​org/​10.​1128/​JCM.​01185-16. A multicenter study regarding the use of multiple real-time quantitative PCR assays of formalin-fixed paraffin-embedded tissue specimens to identify Aspergillus , Fusarium , Scedosporium , and Mucormycetes. CrossRef
42.
go back to reference Montone KT, Litzky LA, Feldman MD, Peterman H, Mathis B, Baliff J, et al. In situ hybridization for Coccidioides immitis 5.8S ribosomal RNA sequences in formalin-fixed, paraffin-embedded pulmonary specimens using a locked nucleic acid probe. A rapid means for identification in tissue section. Diagn Mol Pathol. 2010;19(2):99–104. https://doi.org/10.1097/PDM.0b013e3181b3aa55.CrossRefPubMed Montone KT, Litzky LA, Feldman MD, Peterman H, Mathis B, Baliff J, et al. In situ hybridization for Coccidioides immitis 5.8S ribosomal RNA sequences in formalin-fixed, paraffin-embedded pulmonary specimens using a locked nucleic acid probe. A rapid means for identification in tissue section. Diagn Mol Pathol. 2010;19(2):99–104. https://​doi.​org/​10.​1097/​PDM.​0b013e3181b3aa55​.CrossRefPubMed
46.
54.
56.
57.
go back to reference Gori S, Drouhet E, Gueho E, Huerre M, Lofaro A, et al. Cutaneous disseminated mycosis in a patient with AIDS due to a new dimorphic fungus. J Mycol Med. 1998;8:57–63. Gori S, Drouhet E, Gueho E, Huerre M, Lofaro A, et al. Cutaneous disseminated mycosis in a patient with AIDS due to a new dimorphic fungus. J Mycol Med. 1998;8:57–63.
77.
go back to reference Frickmann H, Loderstaedt U, Racz P, Tenner-Racz K, Eggert P, Haeupler A, et al. Detection of tropical fungi in formalin-fixed, paraffin-embedded tissue: still an indication for microscopy in times of sequence-based diagnosis? BioMed Res Intern. 2015;2015:938721. https://doi.org/10.1155/2015/938721. Frickmann H, Loderstaedt U, Racz P, Tenner-Racz K, Eggert P, Haeupler A, et al. Detection of tropical fungi in formalin-fixed, paraffin-embedded tissue: still an indication for microscopy in times of sequence-based diagnosis? BioMed Res Intern. 2015;2015:938721. https://​doi.​org/​10.​1155/​2015/​938721.
83.
100.
go back to reference Ruangritchankul K, Chindamporn A, Worasilchai N, Poumsuk U, Keelawat S, Bychlov A. Invasive fungal disease in university hospital: a PCR-based study of autopsy cases. Int J Exp Pathol. 2015;8:14840–52. Ruangritchankul K, Chindamporn A, Worasilchai N, Poumsuk U, Keelawat S, Bychlov A. Invasive fungal disease in university hospital: a PCR-based study of autopsy cases. Int J Exp Pathol. 2015;8:14840–52.
Metadata
Title
Challenges in the Diagnosis of Invasive Fungal Infections in Immunocompromised Hosts
Authors
Spinello Antinori
Mario Corbellino
Carlo Parravicini
Publication date
01-03-2018
Publisher
Springer US
Published in
Current Fungal Infection Reports / Issue 1/2018
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-018-0306-0

Other articles of this Issue 1/2018

Current Fungal Infection Reports 1/2018 Go to the issue

Clinical Pathology (S Challa, Section Editor)

Pathogenesis and Pathology of Invasive Aspergillosis

Epidemiology of Fungal Infections (T Chiller and JW Baddley, Section Editors)

A Case for Antifungal Stewardship

Epidemiology of Fungal Infections (T Chiller and JW Baddley, Section Editors)

Epidemiology of Histoplasmosis

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.