ArticleJournal of translational internal medicine2026
Asian consensus on diagnostic algorithm for invasive pulmonary fungal diseases in high-burden settings.
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73 authors.
Wenjie FangShanghai Key Laboratory of Molecular Medical Mycology, Center for Basic Research and Innovation of Medicine and Pharmacy, Ministry of Education of the PRC, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
Xinyao LiuLaboratory of Pathogen Research, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Hazrat BilalJiangxi Key Laboratory of Oncology, Jiangxi Cancer Hospital & Institute, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
Mohammad Daud HabibPulmonology department, Amiri Medical Complex, Kabul, Afghanistan.
Ahmed Nasir HanifiCentral Public Health Laboratory (CPHL), Ministry of Public Health (MoPH), Kabul, Afghanistan.
Nek Wali Shah MominFrench Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
Cornelia Lass-FlörlInstitute of Hygiene and Medical Microbiology, ECMM Excellence Center of Medical Mycology, Medical University of Innsbruck, Innsbruck, Austria.
Chin SamnangAdvisors to the Royal Government of Cambodia, Phnom Penh, Cambodia.
Li AnDepartment of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Multimodal Intelligent Diagnosis and Treatment System for Respiratory Diseases, Beijing, China.
Cunwei CaoDepartment of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Jiangsu Province, China.
Min ChenDepartment of Dermatology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
Zhongju ChenDepartment of Microbiology Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Shuwen DengDepartment of Medical Microbiology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu Province, China.
Li FanDepartment of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China.
Jie GongNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Bing GuLaboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
Jian GuoDepartment of Laboratory Medicine, Shanghai East Hospital affiliated to Tongji University, Shanghai, China.
Xiaoping HuangDepartment of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Yingqian KangGuizhou Key Laboratory of Microbiome and Infectious Disease Prevention & Control, School of Basic Medical Science, Institution of One Health Research, Guizhou Medical University, Gui'an New District, Guizhou Province, China.
Guanzhao LiangDepartment of Medical Mycology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
Likai LinHospital Management Institute of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China.
Jiayun LiuDepartment of Clinical Laboratory Medicine, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China.
Weida LiuDepartment of Medical Mycology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
Shiyuan LiuDepartment of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China.
Wei LiuDepartment of Dermatology and Venereology, Peking University First Hospital; National Clinical Research Center for Skin and Sexually Transmitted Diseases; Beijing Key Laboratory of Innovative Clinical Research and Translation in Skin Diseases; Research Center for Medical Mycology, Peking University, Beijing, China.
Zhengtu LiState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, Guangdong Province, China.
Zhuozhe LiDepartment of pulmonary medicine, Zhongshan hospital. Fudan University, Shanghai, China.
Binghuai LuLaboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Zhiming LuDepartment of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China.
Yuxing NiDepartment of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiaosong QinDepartment of Laboratory Medicine, Liaoning Clinical Research Center for Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
Haibo QiuJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu Province, China.
Yiqing QuDepartment of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
Dongmei ShiThe Laboratory of Medical Mycology & Department of Dermatology, Jining No. 1 People's Hospital, Jining, Shandong Province, China.
Yi ShiDepartment of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China.
Xin SuDepartment of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China.
Hao TangDepartment of Respiratory and Critical Care Medicine, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
Minggui WangInstitute of Antibiotics, Huashan Hospital Fudan University, Shanghai, China.
Yong WangDepartment of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China.
Junxue WangDepartment of Infectious Diseases, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
Wenjuan WuDepartment of Laboratory Medicine, Shanghai East Hospital affiliated to Tongji University, Shanghai, China.
Bin XuJiangxi Key Laboratory of Oncology, Jiangxi Cancer Hospital & Institute, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
Jinfu XuDepartment of Respiratory and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Yingchun XuDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Feng YeState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, Guangdong Province, China.
Yunsong YuDepartment of Infectious Diseases, Center of General Practice Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, China.
Liping ZhuDepartment of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Lin ZhouDepartment of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
Zhiyong ZongLaboratory of Pathogen Research, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Abdella GemechuHaramaya University, College of Health and Medical Sciences, School of Medical Laboratory Sciences, Harar, Ethiopia.
Surajit De MandalDepartment of Microbiology, Shri Davara University, Chhattisgarh, India.
Pratibha GaurDepartment of Biotechnology & Microbiology, Sri Ramaswamy Memorial University, Delhi-National Capital Region, Sonepat, Haryana, India.
Francesco BarchiesiDepartment of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy.
Giuseppina CaggianoHygiene Section, Interdisciplinary Department of Medicine University of Bari Aldo Moro Bari, Bari, Italy.
Bahareh AbbasiGenetic Lab, National Institute for Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran.
Hamid Reza JamaatiMashi Daneshvari Hospital, Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shahla Mohammad GanjiDepartment of Molecular Medicine, Medical Biotechnology Institute, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran.
Sarah A AhmedDepartment of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Khaled AlobaidMicrobiology Department, Mycology Reference Laboratory, Mubarak Al-Kabeer Hospital, Kuwait City, Kuwait.
Leslie Thian Lung ThanDepartment of Medical Microbiology, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia.
Abdullah M S Al-HatmiNatural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman.
Afreenish AmirRawalpindi Medical University, Rawalpindi, Pakistan.
Irum MehmoodHayatabad Medical Complex Peshawar, Peshawar, Pakistan.
Matiur RahmanHealth Services Academy, Islamabad, Pakistan.
Montarop SudhadhamDepartment of Biology, Faculty of Science and Technology, Suan Sunandha Rajabhat University, Bangkok, Thailand.
Macit İlkitDivision of Mycology, Department of Microbiology, Faculty of Medicine, Çukurova University, Adana, Türkiye.
Pham Quynh HoaMycology and Parasitology Department, National Hospital of Dermatology and Venereology, Hanoi, Vietnam.
He WangDynamiker Sub-Center of Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Disease, Tianjin, China.
Pham Hong NhungDepartment of Microbiology Hanoi Medical University, Hanoi, Vietnam.
Thi Duyen ThiDepartment of Dermatology, 108 Military Central Hospital, Hanoi, Vietnam.
Wanqing LiaoShanghai Key Laboratory of Molecular Medical Mycology, Center for Basic Research and Innovation of Medicine and Pharmacy, Ministry of Education of the PRC, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.ORCID https://orcid.org/0000-0003-4454-5988
Xiaojun HuangPeking University People's Hospital, Peking University Institute of Hematology, Beijing, China.ORCID https://orcid.org/0000-0002-3976-6260
Weihua PanShanghai Key Laboratory of Molecular Medical Mycology, Center for Basic Research and Innovation of Medicine and Pharmacy, Ministry of Education of the PRC, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.ORCID https://orcid.org/0000-0001-8077-023X
Funding
No grant is acknowledged in the PubMed record.
Abstract
Invasive pulmonary fungal diseases (IPFD) continue to posing an increasing clinical and public health burden on immunocompromised populations. In many Asian settings, the diagnosis of IPFD faces substantial challenges driven by the high prevalence of comorbidities, including poorly controlled diabetes, tuberculosis (TB), and human immunodeficiency virus (HIV) infection, considerable heterogeneity in local pathogens, and disparities in access to diagnostic resources. To address these unmet needs, experts from 18 countries collaboratively developed this consensus, which provides a diagnostic algorithm tailored to high-burden Asian settings based on existing international and regional guidelines. When clinical manifestations are atypical or diagnostic clues are limited, the algorithm prioritizes evaluation for common and regionally prevalent IPFD, followed by stepwise expansion to other potential fungal pathogens. In addition, this consensus outlines the regional accessibility of different diagnostic modalities across Asia. This consensus focuses exclusively on optimization of the diagnostic algorithm and does not provide specific recommendations regarding antifungal therapy. Notably, improved diagnosis of IPFD through this algorithm may contribute to better patient outcomes and strengthened public health strategies in high-burden regions.
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consensusdiagnostic algorithmimmunocompromised hostinvasive pulmonary fungal diseases
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