Lionakis and Kontoyiannis identified findings which can help determine if a patient with a saprophytic mold isolated in respiratory tract cultures has invasive mold disease or a simple contaminant. This can help identify those patients who require more aggressive diagnosis and treatment. The authors are from the University of Texas M.D. Anderson Cancer Center in Houston.
Findings that favor invasive mold disease:
(1) high-risk patient (see below)
(2) fungal hyphae seen in a sputum smear or in BAL cytology
(3) The same mold isolated more than once in cultures.
(4) recovery of Scedosporium or Paecilomyces species
High-risk patient - one or more of the following:
(1) allogeneic bone marrow transplant
(2) leukemia
(3) high dose corticosteroid therapy
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