EORTC/MSGERC Invasive Fungal Disease Definitions
Classifies invasive fungal disease as proven, probable, or possible under the EORTC and MSGERC consensus definitions.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Recent neutropenia below 0.5 x 10^9/L for more than 10 days
- Yes
- Pulmonary cavity
- Yes
- Serum or plasma galactomannan at 1.0 or above
- Yes
Result: probable invasive fungal disease: 1 host factor, 1 clinical feature, 1 item of mycological evidence
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Proven
- Fungal invasion shown by histopathology, cytopathology or direct microscopy from a normally sterile site, or a culture from a normally sterile site. No host factor is required.
- Probable
- A host factor and a clinical feature and mycological evidence. All three.
- Possible
- A host factor and a clinical feature, with no mycological evidence.
- What they are for
- Research definitions, written to make clinical trials comparable. They are not a decision about whether to treat an individual patient.
- Possible is not a tier of treatment
- It is an epidemiologic category. A case that stops there is one in which mycological evidence has not been obtained, not one in which disease is established.
- No host factor
- A case cannot reach probable or possible however ill the patient is. Disease acquired in intensive care without a host factor is outside what these definitions describe.
What you enter
- Fungal invasion from a normally sterile site by histopathology, cytopathology, direct microscopy or culture
- Recent neutropenia below 0.5 x 10^9/L for more than 10 days (host factor)
- Hematologic malignancy (host factor)
- Allogeneic stem cell transplant (host factor)
- Solid organ transplant (host factor)
- Corticosteroids at 0.3 mg/kg prednisone equivalent or more for 3 weeks or more in the past 60 days (host factor)
- Treatment with recognized T-cell or B-cell immunosuppressants in the past 90 days (host factor)
- Inherited severe immunodeficiency (host factor)
The other 14 fields
- Acute graft-versus-host disease, grade III or IV (host factor)
- Dense, well-circumscribed pulmonary lesion, with or without a halo sign (clinical feature)
- Air-crescent sign (clinical feature)
- Pulmonary cavity (clinical feature)
- Wedge-shaped, segmental or lobar consolidation (clinical feature)
- Tracheobronchial ulceration, plaque, eschar or pseudomembrane on bronchoscopy (clinical feature)
- Sinonasal disease with bone erosion or extension beyond the sinus (clinical feature)
- Focal brain lesion on imaging, or meningeal enhancement (clinical feature)
- Disseminated disease: chorioretinitis, or small peripheral target abscesses in liver or spleen (clinical feature)
- Mold in sputum, lavage, bronchial brush or sinus aspirate by cytology, microscopy or culture (mycological evidence)
- Serum or plasma galactomannan at 1.0 or above (mycological evidence)
- Bronchoalveolar lavage galactomannan at 1.0 or above (mycological evidence)
- Serum galactomannan at 0.7 or above with a lavage value at 0.8 or above (mycological evidence)
- Aspergillus PCR positive on the pattern the definitions accept (mycological evidence)
How this is calculated
Donnelly JP, Chen SC, Kauffman CA, et al. Revision and Update of the Consensus Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020;71(6):1367-1376. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.