Current diagnostic approach to fungal infection in the critically ill patient.

Invasive fungal infections are a major cause of morbidity and mortality in critically ill patients, with an increasing global incidence and species diversity, especially after the SARS-CoV-2 pandemic. Diagnosis relies on a combination of classical methods (microscopy, culture) and non-classical tools including biomarkers (1,3-β-D-glucan, galactomannan, mannan) and molecular assays. Fungal infections (candidiasis, aspergillosis, pneumocystosis, and mucormycosis) requires tailored diagnostic strategies based on host risk factors, epidemiology and specimen type. Combining diagnostic tests improves sensitivity and negative predictive value, guiding timely antifungal treatment. An integrated, pathogen-specific approach is essential to improve outcomes in the critical ill patient.