Histopathological Diagnosis of Fungal Infections: Problems and Prospects

Abstract

Fungal infections (mycoses) are world wide in distribution and the incidence is expected to rise especially as HIV/AIDS and other chronic debilitating medical conditions and immunosuppressive therapies are prevalent in recent times, therefore prompt and accurate diagnosis of mycosis will reduce the morbidity and mortality associated with fungal infections. Histopathology is a major diagnostic tool in mycology and has the advantage of rapid diagnosis, cost effectiveness, ability to provide initial identification of the infecting fungus and demonstrates tissue reactions and currently the means of diagnosing the infections caused by the fungi: Lodoa loboi and Rhinosporidium seeberi. The problem of diagnosing fungal infections using histopathology include: late request for histopathological diagnosis due to late presentation of the patients, low index of suspicion by the clinicians and delay in getting surgical biopsy; limitations of Haematoxylin and Eosin (H&E) in morphological identification
of fungal organisms especially when few organisms are present or distorted and masked by tissue reactions; problems of specificity and sensitivity of histochemistry and immuhistochemistry in fungal diagnosis. The prospects of maximizing the benefits and potentials of histopathology in the diagnosis of mycoses lies in the prompt requests in all suspected cases, use of H&E, histochemical stains like Gomori’ methenamine silver stain (GMS), Periodic Acid Schiff (PAS), and highly specific and sensitive monoclonal based immunohistochemistry. It is concluded that the problems not with standing the prospects are encouraging with improved technological innovations.

Key words: Histopathological Diagnosis Fungal Infections