Early diagnosis and preemptive therapy of pulmonary mold infections in high-risk patients.

The management of pulmonary mold infections in at-risk patients is hampered by the difficulty in diagnosing these infections. Therefore, most practitioners rely on universal prophylaxis and on the early empirical use of antifungals, especially in neutropenic cancer patients and stem cell transplant recipients. However, a strategy of preemptive or diagnostic-driven antifungal therapy is being explored based on advances in imaging techniques and in fungal antigen detection methods. This article highlights the controversies surrounding the prevention and the early treatment of invasive mold infections in high-risk patients.