Aspergillosis Scedosporium Fusariosis Mucormycosis Phaeohyphomycosis Pathogen detection Microscopy techniques [130 ] Color Hyaline Hyaline Hyaline Hyaline Brown Size 3–8 microns wide 3–8 microns wide 3–8 microns wide 5–15 microns wide Variable Septation Yes (no adventitious forms) Yes (+/−adventitious forms: yeast-like structures) Yes (+/−adventitious forms: yeast-like structures) No or pseudoseptation Yes Branching Dichotomous acute angle (45°) Dichotomous acute angle (45°) Dichotomous acute/right angle Irregularly right angle Variable Culture [3 , 57 , 125 ] Among 128 IA in SOT: All samples: Sens: 91.4% Sputum or BAL: PVP: 58%** Blood culture: limited utilityAmong 23 SOT : No positive blood culture In HSCT: Blood culture Sens: 50% Among : blood culture Sens: 41%–60% Blood culture: limited utility Culture of CSF and urine often negative for kidney or CNS infection Blood culture: limited utility PCR [72 , 126 , 131 , 132 ] Among HSCT: Blood: Sens 0.88, Spe 0.75 (0.87 if 2 consecutive positive samples). High NPVAmong lung SOT: BAL: Sens 100%, Spe 88% (pan-Aspergillus PCR)Insufficient data Insufficient data Moderately supported. Fresh material is preferred over paraffin-embedded tissue because formalin damages DNA. Insufficient data Beta-D-glucan assay [133 , 134 ] Among SOT: Sens: 66% Spe: 44% NA Few data but case report with positive results Negative Few data but case report with positive results Galactomannan Ag [70 , 135 , 136 ] Among SOT Serum/BAL: Sens: 22%/81.8% Spe: 84%/95.8%NA In HSCT: Sens 83% & Spe 67% Positive before the diagnosis in 73% at a median of 10 days Negative Cross reactivity in some cases Not recommended Identification species by molecular method [72 , 126 , 132 , 137 ] Required in 10% of cases because of cryptic species with particular antifungal resistance pattern Marginally recommended Marginally recommended Recommended to establish epidemiological knowledge (and in case of healthcare-associated mucormycosis and outbreaks) Recommended especially for unusual or newly described pathogens. Antifungal susceptibility testing to guide treatment [72 , 126 , 132 ] Not recommended in routine in area of low frequency of resistance. Marginally recommended Marginally recommended Moderately recommended Strongly recommended for deep infections