ABSTRACT
INTRODUCTION Despite the availability of broad spectrum antifungal drugs, invasive fungal infection (IFI) remains a major cause of morbidity and mortality in immunosuppressed patients as well as among critically ill patients in the intensive care unit (ICU). Early initiation of appropriate antifungal therapy appears to improve outcomes, especially in neutropenic patients (1,2). Unfortunately, clinical risk assessment in conjunction with physical examination and radiography is often neither sensitive, nor specific enough to make a rapid diagnosis of IFI. The clinical utility of fungal culture is also limited. Cultures frequently remain negative or only become positive in the advanced stages of infection. Furthermore, deciphering colonization from invasive infection can be extremely difficult when samples are obtained from nonsterile sites. Histopathologic examination of infected tissue has historically been the diagnostic gold standard, but invasive testing may not be feasible in critically ill patients or in those with underlying coagulopathy.
