Laboratory methods for the diagnosis and confirmation of systemic mycoses

The concomitant use of culture and nonculture techniques for the diagnosis and confirmation of systemic mycotic infections is recommended and assessed. A diagnosis based upon a single specimen and method, especially when the results are negative, is not always conclusive. In many situations, a single specimen and test method cannot be relied upon for the diagnosis of a fungal infection. The testing of multiple or serial specimens with a battery of procedures increases the chances for establishing a rapid and definitive diagnosis. Positive cultures generally provide unequivocal evidence of infection. In the absence of such data, results obtained by the use of nonculture techniques such as direct examination, conventional and immunohistologic staining, exoantigen identification, DNA hybridization, immunodiffusion, complement fixation, enzyme immunoassay, and radioimmunoassay can allow detection and identification of the etiologic fungus or provide immunologic evidence of a specific fungal infection.