Tests & diagnoses

The set of tests required to make a proven, probably or possible diagnosis of a fungal infection or allergy is usually set out in the guidelines for that disease, and will depend on patient factors as well as local availability of laboratory and imaging facilities.

Generally multiple tests will be required because there are often many conditions in the differential diagnosis, and fungal infections may co-exists with other infections (e.g. influenza with aspergillosis) or diagnoses (e.g. bronchiectasis and aspergillosis).

Laboratory tests explained, including current suppliers

AntibodyAntigen & β-D-glucanCulture
Fungal microscopyHistopathologyMolecular

Find out more about how to perform specimen collection. When submitting hair/skin/nail samples, always include plenty of sample material. Contact your local mycology reference centre for specific packaging requirements.

Imaging & examinations

Imaging / radiology
– Choosing an appropriate modality
– CT
– MRI
Specialist clinical examinations
Dermoscopy
– Opthalmoscopy
– Skin testing for endemic mycoses

Why carry out identification?

  • Knowing which fungus is involved guides appropriate antifungal choice, dose and duration of therapy. It may also indicate the source of infection.
  • Additional or dual infections can often be identified (i.e. 3-5% of Candida bloodstream infections).
  • Severity of infection may be revealed from the extent of involvement on skin or scans, the number or load of organisms visible on microscopy or histology, or the strength of signal on antigen or PCR tests. These factors may assist in determining whether additional therapy should be added and in following response to therapy.
  • Assessing whether antifungal resistance is present, and whether an alternative antifungal agent is required.

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