Non-conventional diagnostic methods for invasive fungal infections

Introduction Biomarkers have revolutionized the field of fungal diagnostics by enabling early detection, risk assessment, and monitoring treatment response. Their value in clinical practice is influenced by a wide range of determinants including diagnostic performance (sensitivity and specificity), predictive value in diverse patient groups, host immune status and comorbidities, technical standardization and antifungal treatment.Area covered This review provides a comprehensive overview of the current antigen and DNA-based methods used for the detection of invasive fungal infections (IFIs), with a particular focus on the clinically significant pathogens Aspergillus spp. Candida spp. and Mucorales. It examines the advantages and limitations of the available diagnostic tools, emphasizing their role in early detection, specificity, and clinical application.Expert Opinion The selection of fungal biomarkers should be tailored based on the patient population, the clinical setting, and the type of fungal infection suspected. Using a combination of biomarkers often improves diagnostic accuracy, particularly in high-risk populations like hematologic malignancy patients. Fungal biomarkers do not provide definitive proof of an active fungal infection; instead, they serve as indirect indicators of the presence of fungal components. Their primary role is to support the diagnosis, assess risk, and guide clinical decisions, but they must be interpreted within the broader clinical context to follow current guidelines for diagnosing fungal infections (EORTC/MSG).