Recommendations for the Clinical Use of Diagnostic Tools in Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Turkish Expert Opinion (TEO-3)

Abstract

The difficulties in the diagnosis of invasive fungal disease (IFD) in hematological malignancies and the proper use of the diagnostic tests are among the important problems the clinician face. Although, the defi nitions of IFD from the European Organization for Research and Treatment of Cancer (EORTC) and Mycosis Study Group (MSG) are aimed to standardize the subject, these are only for clinical research. Especially, the diffi culty of mycological diagnosis and the necessity of immediate intervention in molds have led to the adoption of “surrogate markers” which does not verify, but strongly suggests fungal infection. The markers commonly used are galactomannan (GM), beta-glucan and imaging methods. Although there are numerous studies on these diagnostic approaches, none of these markers serve as a support for the clinician, as is in human immunodefi ciency virus (HIV) or cytomegalovirus (CMV) infections. Clinician has an important role in diagnosis and he/she have to make the correct decision by corroborating these diagnostic tools with clinical state of the patient and the available epidemiological data.This paper has been prepared to show the clinician how the available resources can be used. As molecular tests have not been standardized and not used routinely in the clinics, they will not be mentioned here.

Keywords

• Diagnosis
• Invasive fungal infection
• Imaging
• Serology
• EORTC-MSG