Symptoms and diagnosis of nosocomial fungal infections -- state-of-the-art.

Signs and symptoms of invasive fungal infections are seldom specific and no single mycological test can yield a diagnosis. Recently the Invasive Fungal Infections Cooperative Group (IFICG) of the European Organisation for Research and Treatment of Cancer and the Mycoses Study Group (MSG) of the National Institute of Allergy and Infectious Diseases proposed a framework consisting of 3 elements, namely, host factors, clinical features and mycological evidence which should allow a diagnosis to be assigned in terms of the degree of certainty for patients with cancer and recipients of an HSCT. These definitions allow optimal use to be made of risk factors, advances in imaging techniques and new laboratory tests which provide indirect evidence of fungal involvement. This should make diagnosis more consistent and allow studies of prevention, therapy and epidemiology to be undertaken more efficiently.