Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in immunocompromised patients [1–3]. Host factors such as severe and prolonged neutropenia, allogeneic stem cell transplantation, prolonged use of corticosteroids, prolonged hospitalization at an intensive care unit (ICU), and receipt of recognized T cell immunosuppressants may predispose patients for developing IFI [IFIs have a wide spectrum of clinical presentations, and diagnoses mostly rely on laboratory-based results. Culture-based methods are valuable but limited by time to results, and due to the relatively insensitive for the detection of fungal pathogens [. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a very promising development for identification of culture isolates. MALDI-TOF testing is simple to perform, accurate, can technically identify nearly every organism, and may even detect resistance. Nevertheless, impact of MALDI-TOF testing on early diagnosis and treatment of IFIs is limited, as a positive culture result is a prerequisite for that method. Currently, amplification-based assays are under development that may ultimately replace culture-based tests in the laboratory [. Amplification-based assays may provide results to the laboratory within 20 min to 5 h. New multiplex polymerase chain reactions (PCRs) are often able to detect a selection of multiple pathogens in a single session . However, currently available amplification assays are mostly limited by relatively high costs, inconsistent performance in terms of sensitivities and specificities, and lack of standardization. Loop-mediated isothermal amplification (LAMP) is a cheaper and more simple technique than traditional PCR, and therefore an advantageous alternative, providing results to the laboratory in less than 60 mi Thus, LAMP for diagnosis of histoplasmosis will be discussed in this review.
Important advances have been made during the last years in particular with regard to POC diagnosis of cryptococcosis but also for IA. The CrAg LFD not only has excellent sensitivity over all four serotypes of Cryptococcus but is also FDA approved and commercially available; commercial availability of the Aspergillus LFD is still pending. While LAMP may offer significant advancement in the diagnosis of histoplasmosis, the search for reliable POC tests for other fungi continues.