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Diagnostic Methods

The diagnosis of mucormycosis at early stage is difficult (Skiada et al., 2018). Typically, it involves the combination of clinical evaluation, imaging, and laboratory tests (Hussain et al., 2023). Physical examination of the patient is the first step which investigates the primary symptoms of the disease such as fever, headache, facial pain, nasal congestion, visual abnormalities, and occasionally even the presence of black lesions on the skin or mucosal surface (Prakash & Chakrabarti, 2019). Following a physical examination, a variety of diagnostic techniques can be used to determine whether mucormycosis has occurred. The histopathological analysis has made to identify the characteristic features of the fungus involved in the disease cause using staining such as Grocott's methenamine silver (GMS) and periodic acid‐Schiff (PAS) staining (Ponnaiyan et al., 2023). The imaging techniques preferably used for the diagnosis of mucormycosis are computed tomography (CT) scans and magnetic resonance imaging (MRI) (Ponnaiyan et al., 2023). Molecular methods are used for the identification of fungi on genus and species level. The Polymerase chain reaction (PCR) based techniques are typically preferred for thorough disease analysis in its early stages (Baldin et al., 2018). Multiple serological methods have also been used for the diagnosis of fungal infections including enzyme immunoassays, immunodiffusion, Lateral flow tests, etc., (Dadwal & Kontoyiannis, 2018). There are detailed guidelines provided by Cornely et al., for the diagnosis and management of mucormycosis (Cornely et al., 2019)]. PONNAIYAN et al., also provides the advanced and possible future diagnostic methods as well that can be used for the diagnosis of mucormycosis (Ponnaiyan et al., 2023).

References:

  1. Skiada, A., Lass-Floerl, C., Klimko, N., Ibrahim, A., Roilides, E., & Petrikkos, G. (2018). Challenges in the diagnosis and treatment of mucormycosis. Medical Mycology, 56, S93–S101. https://doi.org/10.1093/mmy/myx101
  2. Hussain, M. K., Ahmed, S., Khan, A., Siddiqui, A. J., Khatoon, S., & Jahan, S. (2023). Mucormycosis: A hidden mystery of fungal infection, possible diagnosis, treatment and development of new therapeutic agents. European Journal of Medicinal Chemistry, 246, 115010. https://doi.org/10.1016/j.ejmech.2022.115010
  3. Prakash, H., & Chakrabarti, A. (2019). Global Epidemiology of Mucormycosis. Journal of Fungi (Basel, Switzerland), 5(1). https://doi.org/10.3390/jof5010026
  4. Ponnaiyan, D., Anitha, C. M., Prakash, P. S. G., Subramanian, S., Rughwani, R. R., Kumar, G., & Nandipati, S. R. (2023). Mucormycosis diagnosis revisited: Current and emerging diagnostic methodologies for the invasive fungal infection (Review). Experimental and Therapeutic Medicine, 25(1), 47. https://doi.org/10.3892/etm.2022.11746
  5. Baldin, C., Soliman, S. S. M., Jeon, H. H., Alkhazraji, S., Gebremariam, T., Gu, Y., Bruno, V. M., Cornely, O. A., Leather, H. L., Sugrue, M. W., Wingard, J. R., Stevens, D. A., Edwards, J. E. J., & Ibrahim, A. S. (2018). PCR-Based Approach Targeting Mucorales-Specific Gene Family for Diagnosis of Mucormycosis. Journal of Clinical Microbiology, 56(10). https://doi.org/10.1128/JCM.00746-18
  6. Dadwal, S. S., & Kontoyiannis, D. P. (2018). Recent advances in the molecular diagnosis of mucormycosis. Expert Review of Molecular Diagnostics, 18(10), 845–854. https://doi.org/10.1080/14737159.2018.1522250
  7. Cornely, O. A., Alastruey-Izquierdo, A., Arenz, D., Chen, S. C. A., Dannaoui, E., Hochhegger, B., Hoenigl, M., Jensen, H. E., Lagrou, K., Lewis, R. E., Mellinghoff, S. C., Mer, M., Pana, Z. D., Seidel, D., Sheppard, D. C., Wahba, R., Akova, M., Alanio, A., Al-Hatmi, A. M. S., … Chakrabarti, A. (2019). Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. The Lancet. Infectious Diseases, 19(12), e405–e421. https://doi.org/10.1016/S1473-3099(19)30312-3

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