An Approach to Fungal Diagnostics in Solid Organ Transplantation

The approach to diagnosing fungal infections following solid organ transplantation (SOT) is patient-specific. An assessment of an individual’s risk for particular infections, also understood as the pre-test probability, should guide appropriate diagnostic testing whereas diagnostic stewardship is needed to produce interpretable, actionable and cost-sensitive results. This review provides a cognitive framework for practitioners aiming to diagnose fungal infections in recipients of SOT, taking into consideration the benefits and limitations of currently available diagnostic platforms. In order to better characterize diagnostic utility for this population, we focus on clinical studies that include patients with SOT in full or in part. The goal of this review is to improve the diagnosis of fungal infections in patients with SOT by encouraging a thoughtful, systematic diagnostic approach.