Post-COVID-19 invasive fungal infections in pulmonary ICU patients: Diagnosis, management, and clinical challenge

Invasive fungal infections (IFIs) are among the most significant and challenging complications in critically ill patients, particularly those with underlying pulmonary diseases. Common causative organisms include Aspergillus, Candida, and Mucorales, which are associated with high morbidity and mortality due to delayed diagnosis, nonspecific clinical presentation, and host immune suppression. This narrative review provides a comprehensive overview of the epidemiology, pathophysiology, diagnostic methods, therapeutic options, and clinical challenges of pulmonary IFIs in intensive care unit (ICU) patients. Risk factors, advances and limitations in imaging, laboratory diagnostics including cultures, biomarkers, and molecular techniques, as well as antifungal treatment strategies are discussed. The review also addresses emerging issues such as antifungal resistance, adjunctive therapies, and the critical role of early recognition in improving clinical outcomes. The aim is to guide ICU clinicians in the effective management of critically ill pulmonary patients with invasive fungal infections while highlighting future research directions.