Table 1.
Current approaches to diagnose T. marneffei infection.
| Diagnosis Approach | Specimen | Target | References | Advantages | Disadvantages |
|---|---|---|---|---|---|
| Culture-based | Blood, skin, bone marrow, or lymph node biopsy | Physical presence of T. marneffei | [13,35,61] | High specificity | Too slow, delays therapeutic intervention, and limited sensitivity (disseminated infection) |
| Microscopy | Blood, skin, bone marrow, or lymph node biopsy | Physical presence of T. marneffei | [35,40] | Quick to perform and high specificity | Requires highly trained microscopists (at least two) and has limited sensitivity (when skin is considered) |
| Antigen/antibody | Blood or urine | Monoclonal antibody (mAb) EB-A1 | [42,43] | Quick to perform, high sensitivity, and specificity | Potential cross-reactions (galactomannan also found in Aspergillus spp. and Cryptococcus neoformans, or elevated levels of β-D-glucan also reported in aspergillosis and candidiasis), and efficacy depends on the specimen used |
| mAb-4D1 | [46,47] | ||||
| mAb-Mp1p | [36,48] | ||||
| PCR-based and mNGS | Blood, skin, bone marrow, lymph nodes, or formalin-fixed and paraffin-embedded (FFPE) samples | 5.8S rRNA | [49] | Quick to perform, high sensitivity, and high specificity | Expensive and unavailable in poor socioeconomic settings |
| 18S rRNA | [50] | ||||
| MP1 | [51] |
Ab: antibody; MP1: mannoprotein 1.