The diagnosis of fungal neglected tropical diseases (Fungal NTDs) and the role of investigation and laboratory tests: An expert consensus report

by Hay R, Denning DW, Bonifaz A, Queiroz-Telles F, Beer K, Bustamante B, Chakrabarti A, Chavez-Lopez MG, Chiller T, Cornet M, Estrada R, Estrada-Chavez G, Fahal A, Gomez BL, Li R, Mahabeer Y, Mosam A, Soavina Ramarozatovo L, Rakoto Andrianarivelo M, Rapelanoro Rabenja F, van de Sande W, Zijlstra EE. Tropical Medicine and Infectious Diseases 2019, 4(4), 122.

Summary: Current tools to diagnose fungal neglected tropical diseases (NTD) in endemic settings are inadequate. The authors conducted a survey of subject matter experts on the optimal diagnostic methods in well-equipped versus basic healthcare settings for three fungal NTDs: mycetoma, chromoblastomycosis, and sporotrichosis. In well-equipped laboratories, semi-invasive sampling methods play a key role, and histopathology, direct microscopy, and culture for mycetoma and chromoblastomycosis are important for confirmation. In basic healthcare settings, direct microscopy combined with clinical signs is most useful. Diagnosis of sporotrichosis is more problematic, highlighting the urgent need for innovation in diagnostics. For mycetoma and sporotrichosis, in particular, advances in identifying specific marker antigens or genomic sequences may pave the way for new laboratory-based or point-of-care tests.

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