Chapters authored
Laboratory Diagnosis of Histoplasmosis: An Update
Early diagnosis of histoplasmosis is essential to establish a suitable antifungal therapy and reduce morbidity and mortality rates. However, laboratory diagnosis remains challenging due to the low availability of proper methods and the lack of clinical suspicion. Conventional diagnosis is still largely used even though limitations are well known. Isolating the fungus is time consuming and requires manipulation in BSL3 facilities, while direct visualization and histopathology techniques show low sensitivity and need skilled personnel. New approaches based on the detection of antibodies and antigens have been developed and commercialized last years. Although sensitivity and specificity of these methods is variable, antigen detection has been recently listed as an essential diagnostic test for AIDS patients due to its excellent performance. DNA detection methods are recognized as promising tools but there is still a lack of consensus among laboratories and there are not commercial tests available. Not all methods are widely available, thus most laboratories combine classical and other tests in order to overcome aforementioned limitations. In this chapter, we review the diagnostic pipeline currently available for the diagnosis of histoplasmosis in microbiological laboratories, from conventional to new developed tests. Most recent approaches are introduced and future perspectives are discussed.
Part of the book: Histoplasma and Histoplasmosis