Translational medical mycology guides clinical and laboratory practice on fungal diseases

Abstract

Patients with fungal infection having skin lesions may consult a dermatologist, which is a diagnostic and therapeutic challenge. Dermatologists take samples from the lesion to check the fungal elements under a microscope by KOH preparation and then treat the patient. This model has advanced from bedside to bench and from bench to bedside (B to B to B), which is defined as Translational Medical Mycology. Dermatologists have an advantageous position in finding, isolating and identifying the pathogenic fungi and treating the patient with antifungal drugs. Samples should be cultured in different media with or without chloramphenicol and cycloheximide and incubated at room temperature or 37 °C. Non-culture techniques such as polymerase chain reaction based molecular identification, transmission electron microscopy, scanning electron microscopy, biochemistry tests and histopathology are also necessary to confirm the identification of the species, especially when the routine culture is negative. We start treatment upon obtaining evidence of fungal infection, i.e., positive KOH examination. Antifungal drugs such as itraconazole, fluconazole, terbinafine and amphotericin B can be used alone or in combination based on the fungal species and the location of the lesion. Practice on fungal infection includes screening of the patient, merging all of the laboratory techniques and methods from the microbiologists, pathologists, molecular researchers, identification of the pathogen and determination of the optimum antifungal drug.

Keywords: Translational; Mycology; Bedside; Bench; Fungal infections

Core tip:“Translational medical mycology” has transformed vastly in recent years, which is aimed to solve clinical problems. This transformation is a dynamic, multi-level, multi-directional and continuously improving process. There are different processes in translational medicine, with the main objective being translation journey from bench to bedside to the community. We can solve a clinical problem by using a number of new technologies with the help of advanced laboratories and professionals, which will eventually promote the overall progress of medical mycology and ultimately provide an access to the effective treatment and prevention of the fungal disease.