Introduction
Respiratory fungal infections are increasingly encountered in clinical practice and can lead to life-threatening invasive diseases. A multi-disciplinary approach has been recommended to provide comprehensive medical care for patients with fungal disease. The Imperial Healthcare NHS Trust Fungal MDT meeting was established in 2017 to discuss patients with suspected fungal lung disease.

Aim
To assess the impact of Fungal MDT discussion on clinical management of patients with suspected pulmonary fungal disease.

Method

The MDT comprising of Respiratory physicians, Microbiologist, Mycologist, Radiologist, Haematologist and an Infection pharmacist convened monthly. Data was collected from the first MDT discussion in 100 consecutive patients.

Results
41% of patients were referred to the MDT to guide management and 31% to establish a diagnosis. A diagnosis was made in 77% of patients and the MDT requested further investigations in 66%. This resulted in a change in management in 71% of patients including a change in treatment duration in 22%, commencing anti-fungal therapy in 16% and stopping treatment in 9% of patients.
59% of the patients had an underlying chronic respiratory diagnosis. The remainder were immunocompromised mostly due to renal/haematological conditions. Non-specific fungal disease including aspergillus lung disease was the commonest diagnosis encountered in 46% of patients. Non-fungal disease was diagnosed in 16%.

Conclusion
Fungal MDTs may be useful in centers with a large population of immunocompromised patients or chronic respiratory disease to increase diagnostic certainty, guide management and promote anti-fungal stewardship.