Table 2.
Etiologic agents | Diagnostic methods |
---|---|
Aspergillosis |
Pleural effusion or Bronchoalveolar lavage fluid |
(i) Direct examination, cultures, histopathologic demonstration | |
(ii) Galactomannan antigen detection, Beta-D-glucan assay*, Polymerase chain reaction | |
Serum | |
(i) Aspergillus antibody test (precipitins) for chronic pulmonary aspergillosis | |
(ii) Aspergillus IgG antibodies, Aspergillus IgE test (precipitins) | |
(iii) Galactomannan and beta-D-glucan levels double sandwich enzyme-linked immunosorbent assay (ELISA) | |
(iv) 1,3-Beta-D-glucan | |
| |
Candidiasis | Blood, CSF, Urine, or other body fluid |
(i) Isolating a Candida species from multiple or repeat cultures | |
(ii) Beta-D-glucan and other antigen and metabolite assays | |
(iii) Polymerase chain reaction | |
| |
Cryptococosis | Cerebrospinal fluid, Blood or Serum, BAL, Urine |
(i) India ink smear | |
(ii) Culture | |
(iii) latex agglutination test or enzyme linked immunosorbent for Cryptococcal antigen testing | |
| |
Mucormycosis | Sterile body fluid from site of infection |
(i) Histopathopathologic examination | |
(ii) Culture | |
| |
Other fungal infection | Sterile body fluid from site of infection |
(i) Histopathopathologic examination | |
(ii) Culture and isolation of fungal species in cultures of involved biologic materials |
*1,3-Beta-D-glucan, a cell wall composition of many fungi, may be positive in patients with a variety of invasive fungal infections, it is typically negative in patients with mucormycosis or cryptococcosis.