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Yamasmith E, Chongtrakool P, Chayakulkeeree M. Isolated pulmonary fusariosis caused by Neocosmospora pseudensiformis in a liver transplant recipient: A case report and review of the literature. Transpl Infect Dis 2020; 22:e13344. [PMID: 32479709 DOI: 10.1111/tid.13344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/28/2020] [Accepted: 05/24/2020] [Indexed: 11/29/2022]
Abstract
Neocosmospora pseudensiformis (formerly Fusarium pseudensiforme) is a hyaline mold in the Fusarium solani species complex that has been changed to the genus Neocosmospora. Invasive fusariosis is a rare fungal infection in solid organ transplantation. The most commonly reported manifestation of invasive fusariosis in this setting is localized cutaneous fusariosis. Here, we present the first case report of isolated N pseudensiformis pulmonary infection in a patient with non-alcoholic steatohepatitis cirrhosis who underwent orthotopic liver transplantation. A 67-year-old Thai woman developed acute graft rejection, dyspnea, and pulmonary consolidation 6 months after liver transplantation. N pseudensiformis was isolated from her sputum, and her clinical symptoms were improved with voriconazole treatment. However, she succumbed to Acinetobacter baumannii hospital-acquired pneumonia and acute coronary syndrome with cardiogenic shock after 10 days of treatment.
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Affiliation(s)
- Eakkawit Yamasmith
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Piriyaporn Chongtrakool
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Methee Chayakulkeeree
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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2
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Rammlmair A, Mühlethaler K, Haneke E. Fusarium onychomycoses in Switzerland-A mycological and histopathological study. Mycoses 2019; 62:928-931. [PMID: 31271679 DOI: 10.1111/myc.12964] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 06/28/2019] [Indexed: 01/15/2023]
Abstract
Onychomycoses in temperate climates are most commonly due to dermatophytes, particularly Trichophyton rubrum. Non-dermatophyte nail infections are much less frequent, and their diagnosis requires a careful and repeated search for a potential dermatophyte that may have been overgrown in culture. A series of histological slides of suspected onychomycoses with uncommon fungal morphology prompted us to search for non-dermatophytic moulds causing dermatophytosis-like nail infections. Thirty cases were identified by culture as F solani, F oxysporum, F dimerum or F spp, and two more were only diagnosed histopathologically. None of these patients was immunocompromised. Treatment was mostly unsuccessful with terbinafine whereas itraconazole showed a moderately better treatment result; in all cases, a topical ciclopirox nail varnish in a hydroxychitosan base was added.
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Affiliation(s)
- Anna Rammlmair
- Department of Dermatology, Inselspital, University of Berne, Bern, Switzerland
| | - Konrad Mühlethaler
- Institut for Infectious Diseases, University of Berne, Bern, Switzerland
| | - Eckart Haneke
- Department of Dermatology, Inselspital, University of Berne, Bern, Switzerland.,Dermatology Practice Dermaticum, Freiburg, Germany.,Centro de Dermatología, Instituto CUF, Matosinhos, Porto, Portugal.,Kliniek Huidziekten, University Hospitals, Gent, Belgium
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3
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Abstract
Fusarium is an emerging human opportunistic pathogen of growing importance, especially among immunosuppressed haematology patients due to an increased incidence of disseminated infections over the past two decades. This trend is expected only to continue due to the advances in medical and surgical technologies that will prolong the lives of the severely ill, making these patients susceptible to rare opportunistic infections. Production of mycotoxins, enzymes such as proteases, angio-invasive property and an intrinsically resistant nature, makes this genus very difficult to treat. Fusarium is frequently isolated from the cornea and less commonly from nail, skin, blood, tissue, Continuous Ambulatory Peritoneal Dialysis (CAPD) fluid, urine and pleural fluid. Conventional microscopy establishes the genus, but accurate speciation requires multilocus sequence typing with housekeeping genes such as internal transcribed spacer, translation elongation factor-1α and RPB1 and 2 (largest and second largest subunits of RNA polymerase), for which expansive internet databases exist. Identifying pathogenic species is of epidemiological significance, and the treatment includes immune reconstitution by granulocyte-colony-stimulating factor, granulocyte macrophage-colony-stimulating factor and a combination of the most active species - specific antifungals, typically liposomal amphotericin-B and voriconazole. However, patient outcome is difficult to predict even with in vitro susceptibility with these drugs. Therefore, prevention methods and antifungal prophylaxis have to be taken seriously for these vulnerable patients by vigilant healthcare workers. The current available literature on PubMed and Google Scholar using search terms 'Fusarium', 'opportunistic invasive fungi' and 'invasive fusariosis' was summarised for this review.
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Affiliation(s)
- Ananya Tupaki-Sreepurna
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Anupma Jyoti Kindo
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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4
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Fusarium Infection in a Kidney Transplant Recipient Successfully Treated with Voriconazole. Case Rep Infect Dis 2018; 2018:3128081. [PMID: 30159184 PMCID: PMC6109559 DOI: 10.1155/2018/3128081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 07/15/2018] [Indexed: 11/18/2022] Open
Abstract
Fusarium infections in solid-organ transplant recipients are rare and carry high mortality. We report a case of a kidney transplant recipient who developed infection with Fusarium species. The patient received treatment with oral voriconazole for five months with good response.
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5
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Nambiar P, Cober E, Johnson L, Brizendine KD. Fatal Fusarium infection manifesting as osteomyelitis following previous treatment with amphotericin B in a multi-visceral transplant: Case report and review of Fusarium infections in solid organ transplantation. Transpl Infect Dis 2018; 20:e12872. [PMID: 29512240 DOI: 10.1111/tid.12872] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/06/2017] [Accepted: 01/01/2018] [Indexed: 12/16/2022]
Abstract
Invasive fusariosis in solid organ transplant is uncommon and usually presents as localized infection with favorable outcomes compared to hematologic malignancies or bone marrow transplants. We report the first case of Fusarium osteomyelitis in a patient following multi-visceral transplant and review Fusarium in organ transplant recipients and Fusarium bone and joint infections. Our case underscores the importance of early recognition and multidisciplinary approach to treatment and highlights potential failure to eradicate with amphotericin B monotherapy.
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Affiliation(s)
- P Nambiar
- Department of Medicine, Section of Infectious Disease, Louisiana State University Health System, Shreveport, LA, USA
| | - E Cober
- Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA
| | - L Johnson
- Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA
| | - K D Brizendine
- Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
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6
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Khetan S, Khetan P, Katkar V, Kusulkar M. Urinary tract infection due to Fusarium oxysporum in an immunocompetent patient with chronic kidney disease. J Biomed Res 2017; 32:157-160. [PMID: 29569576 PMCID: PMC5895570 DOI: 10.7555/jbr.32.20160128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Infections due to Fusarium species are collectively referred to as fusariosis. Fusarium oxysporum has been reported to cause keratitis, onychomycosis, skin infections, catheter associated fungemia and has not been described as a cause of urinary tract infection. Here, we present the first case of fusariosis with urinary tract involvement in a 67 year old male, with chronic kidney disease and type 2 diabetes mellitus. This case illustrates the ever increasing spectrum of rare but offending pathogenic fungi. Early diagnosis of infection with a specific pathogen may lead to changes in antifungal therapy and may be critical for an improved outcome.
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Affiliation(s)
- Seema Khetan
- Department of Microbiology, Government Medical College, Hanuman Nagar, Nagpur 440009, India
| | - Prakash Khetan
- Department of Microbiology, Government Medical College, Hanuman Nagar, Nagpur 440009, India
| | - Venkatesh Katkar
- Department of Microbiology, Government Medical College, Hanuman Nagar, Nagpur 440009, India
| | - Minal Kusulkar
- Department of Microbiology, Government Medical College, Hanuman Nagar, Nagpur 440009, India
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7
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Shah PJ, Bergman S, Vegi S, Sundareshan V. Fusarium peritonitis successfully managed with posaconazole and catheter removal. Perit Dial Int 2015; 34:566-8. [PMID: 25075003 DOI: 10.3747/pdi.2013.00142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Punit J Shah
- Department of Pharmacy, St. John's Hospital, Springfield, Illinois Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, Illinois Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, IllinoisDepartment of Pharmacy, St. John's Hospital, Springfield, Illinois Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, Illinois Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Scott Bergman
- Department of Pharmacy, St. John's Hospital, Springfield, Illinois Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, Illinois Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, IllinoisDepartment of Pharmacy, St. John's Hospital, Springfield, Illinois Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, Illinois Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Srivalli Vegi
- Department of Pharmacy, St. John's Hospital, Springfield, Illinois Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, Illinois Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Vidya Sundareshan
- Department of Pharmacy, St. John's Hospital, Springfield, Illinois Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, Illinois Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, Illinois
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8
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Keskar VS, Wanjare S, Jamale TE, Mahajan D, Jawale SY, Fernandes G, Suryawanshi R, Hase NK. Subcutaneous hyalohyphomycosis caused byFusariumin a kidney transplant recipient. Ren Fail 2014; 36:1129-32. [DOI: 10.3109/0886022x.2014.926756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Muhammed M, Anagnostou T, Desalermos A, Kourkoumpetis TK, Carneiro HA, Glavis-Bloom J, Coleman JJ, Mylonakis E. Fusarium infection: report of 26 cases and review of 97 cases from the literature. Medicine (Baltimore) 2013; 92:305-316. [PMID: 24145697 PMCID: PMC4553992 DOI: 10.1097/md.0000000000000008] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Fusarium species is a ubiquitous fungus that causes opportunistic infections. We present 26 cases of invasive fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria of fungal infections. All cases (20 proven and 6 probable) were treated from January 2000 until January 2010. We also review 97 cases reported since 2000. The most important risk factors for invasive fusariosis in our patients were compromised immune system, specifically lung transplantation (n = 6) and hematologic malignancies (n = 5), and burns (n = 7 patients with skin fusariosis), while the most commonly infected site was the skin in 11 of 26 patients. The mortality rates among our patients with disseminated, skin, and pulmonary fusariosis were 50%, 40%, and 37.5%, respectively. Fusarium solani was the most frequent species, isolated from 49% of literature cases. Blood cultures were positive in 82% of both current study and literature patients with disseminated fusariosis, while the remaining 16% had 2 noncontiguous sites of infection but negative blood cultures. Surgical removal of focal lesions was effective in both current study and literature cases. Skin lesions in immunocompromised patients should raise the suspicion for skin or disseminated fusariosis. The combination of medical monotherapy with voriconazole or amphotericin B and surgery in such cases is highly suggested.
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Affiliation(s)
- Maged Muhammed
- From the Division of Infectious Diseases (MM, TA, AD, TKK, HAC, JG-B, JJC, EM), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts; and Division of Infectious Diseases (TA, JJC, EM), Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
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10
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Tascini C, Urbani L, Doria R, Catalano G, Leonildi A, Filipponi F, Menichetti F. BreakthroughFusariumspp Fungemia During Caspofungin Therapy in an ABO-Incompatible Orthotopic Liver Transplant Patient. J Chemother 2013; 21:236-8. [DOI: 10.1179/joc.2009.21.2.236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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11
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Fusarium falciforme Infection of Foot in a Patient with Type 2 Diabetes Mellitus: A Case Report and Review of the Literature. Mycopathologia 2013; 176:225-32. [DOI: 10.1007/s11046-013-9646-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
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12
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Jossi M, Ambrosioni J, Macedo-Vinas M, Garbino J. Invasive fusariosis with prolonged fungemia in a patient with acute lymphoblastic leukemia: case report and review of the literature. Int J Infect Dis 2010; 14:e354-6. [DOI: 10.1016/j.ijid.2009.05.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 04/17/2009] [Accepted: 05/02/2009] [Indexed: 10/20/2022] Open
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13
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Gaur S, Rajgopal A, Ashbee R. A successfully treated case of peritonitis due to Fusarium dimerum. J Infect 2010; 61:86-8. [PMID: 20359497 DOI: 10.1016/j.jinf.2010.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 01/21/2010] [Accepted: 03/16/2010] [Indexed: 10/19/2022]
Abstract
SUMMARY Fungal peritonitis is a rare but serious complication of continuous ambulatory peritoneal dialysis (CAPD). We report the first known case of CAPD peritonitis due to Fusarum dimerum successfully treated with antifungals and catheter removal.
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Affiliation(s)
- Soma Gaur
- Royal Gwent Hospital, Newport, Wales, UK.
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14
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Kubak BM, Huprikar SS. Emerging & rare fungal infections in solid organ transplant recipients. Am J Transplant 2009; 9 Suppl 4:S208-26. [PMID: 20070683 DOI: 10.1111/j.1600-6143.2009.02913.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- B M Kubak
- Division of Infectious Diseases, David Geffen School of Medicine at UCLA. Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
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15
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Abstract
Fungal peritonitis (FP) is a rare but potentially fatal complication of chronic peritoneal dialysis (PD), associated with high morbidity and mortality ranging between 20% and 30%. If not leading to death, the inflammatory process usually causes irreversible damage to the peritoneal membrane with subsequent dropout from PD therapy. Fungal peritonitis accounts for 3% – 6% of all peritonitis episodes; however, in some areas, the numbers can be much higher. The most common cause of the disease is Candida, predominately C. albicans, C. parapsilosis, and—more recently— C. glabrata; other yeasts and filamentous fungi such as Aspergillus, Paecilomyces, Penicillium, and Zygomycetes are found, but much less frequently. The main factors associated with the development of FP include previous antibiotic therapy, particularly for bacterial peritonitis, when two important operative mechanisms coincide: fungal overgrowth in the gastrointestinal tract and declining peritoneal defense because of peritonitis. The management of FP poses a difficult challenge. Prompt initiation of therapy is critical, but no typical clinical picture has emerged, and the infecting organism can be difficult to isolate. The approach to the disease has changed considerably in recent years, and the 2005 guidelines from the International Society for Peritoneal Dialysis list FP as a strong indication for immediate catheter removal with temporary hemodialysis. The conventional antifungal regimens include fluconazole, amphotericin B, and flucytosine alone or in combination, optimally based on fungal sensitivities. The newer agents such as caspofungin and voriconazole have the potential to alter treatment strategies for FP, but further studies are required to clarify the precise role of these agents in this group of patients.
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16
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Robert-Gangneux F, Degeilh B, Chevrier S, Guiguen C, Gangneux JP. Mycoses profondes et transplantation. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1773-035x(08)73334-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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17
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Current challenges in the management of invasive fungal infections. J Infect Chemother 2008; 14:77-85. [DOI: 10.1007/s10156-007-0595-7] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Indexed: 10/22/2022]
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18
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Abstract
Fusarium species cause a broad spectrum of infections in humans, including superficial, locally invasive, and disseminated infections. The clinical form of fusariosis depends largely on the immune status of the host and the portal of entry, with superficial and localized disease occurring mostly in immunocompetent patients and invasive and disseminated disease affecting immunocompromised patients. Risk factors for severe fusariosis include prolonged neutropenia and T-cell immunodeficiency, especially in hematopoietic stem cell transplant recipients with severe graft-versus-host disease. The most frequent presentation of disseminated fusariosis is a combination of characteristic cutaneous lesions and positive blood cultures, with or without lung or sinus involvement. The prognosis is poor and is determined largely by degree of immunosuppression and extent of infection, with virtually a 100% death rate among persistently neutropenic patients with disseminated disease. These infections may be clinically suspected on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy. Treatment options include the lipid formulations of amphotericin B, voriconazole, and posaconazole. Prevention of fusarial infection among high-risk patients should be considered.
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19
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Shao PL, Huang LM, Hsueh PR. Recent advances and challenges in the treatment of invasive fungal infections. Int J Antimicrob Agents 2007; 30:487-95. [PMID: 17961990 DOI: 10.1016/j.ijantimicag.2007.07.019] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 07/26/2007] [Indexed: 11/28/2022]
Abstract
The frequency of invasive fungal infections (IFIs) has increased over the last decade with the rise in at-risk populations of patients. The morbidity and mortality of IFIs are high and management of these conditions is a great challenge. With the widespread adoption of antifungal prophylaxis, the epidemiology of invasive fungal pathogens has changed. Non-albicans Candida, non-fumigatus Aspergillus and moulds other than Aspergillus have become increasingly recognised causes of invasive diseases. These emerging fungi are characterised by resistance or lower susceptibility to standard antifungal agents. Invasive infections due to these previously rare fungi are therefore more difficult to treat. Recently developed antifungal agents provide the potential to improve management options and therapeutic outcomes of these infections. The availability of more potent and less toxic antifungal agents, such as second-generation triazoles and echinocandins, has led to considerable improvement in the treatment of IFIs. This article reviews the changing spectrum of invasive mycosis, the properties of recently developed antifungal agents and their role in the management of these infections.
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Affiliation(s)
- Pei-Lan Shao
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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20
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Abstract
Fungal infections in solid organ transplant recipients continue to be a significant cause of morbidity and mortality. Candida spp. and Aspergillus spp. account for most invasive fungal infections. The incidence of fungal infection varies with type of solid organ transplant. Liver transplant recipients have highest reported incidence of candida infections while lung transplant recipients have highest rate of Aspergillus infections. Recent epidemiological studies suggest the emergence of resistant strains of candida as well as mycelial fungi other than Aspergillus in these patients. The current review incorporates the recent changes in the epidemiology of fungal infections in solid organ transplant recipients and highlights the newer data on the diagnosis, prophylaxis and treatment of fungal infections in these patients.
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Affiliation(s)
- Fernanda P Silveira
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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21
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Lodato F, Tamé MR, Montagnani M, Sambri V, Liguori G, Azzaroli F, Costigliola P, Grazi G, Roda E, Mazzella G. Systemic fungemia and hepatic localizations of Fusarium solani in a liver transplanted patient: an emerging fungal agent. Liver Transpl 2006; 12:1711-4. [PMID: 17058254 DOI: 10.1002/lt.20899] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The incidence of invasive fungal infection is increasing especially in the field of transplantation, affecting as many as 50% of bone marrow transplant (BMT) patients with neutropenia and 5-20% of solid-organ transplant (SOT) recipients. Fusarium species are soil saprophytes and plant pathogens. They may cause superficial mycoses or important opportunistic infections in patients with bone marrow suppression and neutropenia, they have been rarely described in solid organ recipients, and up to now there have been no reports of such infection in isolated liver transplanted patients. We describe a case of disseminated Fusarium solani infection with hepatic localization in a liver transplanted patient that resolved with the administration of amphotericin B. Our observation confirms that Fusarium spp. are emerging pathogens that may most frequently affect not only BMT patients and patients with hematological malignancies, but also SOT patients. They may cause both localized and disseminated infection. In conclusion, Fusarium spp. etiology should be considered in the context of infectious diseases following liver transplantation.
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Affiliation(s)
- Francesca Lodato
- Department of Internal Medicine and Gastroenterology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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22
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Abstract
The hyalohyphomycetes (especially Fusarium spp) have emerged as significant pathogens in severely immunocompromised patients. Human infections by Fusarium spp can be superficial or limited to single organs in otherwise healthy patients. Such infections are rare and tend to respond well to therapy. By contrast, disseminated fusarial hyalohyphomycosis affects the immunocompromised host and frequently is fatal. Successful outcome is determined by the degree of immunosuppression and the extent of the infection. These infections may be suspected clinically on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy.
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Affiliation(s)
- Marcio Nucci
- Hematology Service, Department of Internal Medicine, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil
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23
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Baden LR, Rubin RH. Darwinian competition and the pathogenesis of opportunistic infection in the transplant recipient. Transpl Int 2005; 18:1223-5. [PMID: 16221150 DOI: 10.1111/j.1432-2277.2005.00150.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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