Evaluation of Human Body Fluids for the Diagnosis of Fungal Infections

Table 2

Diagnostic methods for the detection of opportunistic fungal infections in body fluids.

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.