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Overview of systemic fungal infections
1Section of Infectious Disease, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Abstract:
A steady increase in the frequency of invasive fungal infections has been observed in the past 2 decades, particularly in immunosuppressed patients. In recipients of bone marrow transplants, Candida albicans and Aspergillus fumigatus remain the primary pathogens. In many centers, however, Candida species other than C albicans now predominate, and many cases of aspergillosis are due to species other than A fumigatus. Additionally, heretofore unrecognized and/or uncommon fungal pathogens are beginning to emerge, including Blastoschizomyces capitatus, Fusarium species, Malassezia furfur, and Trichosporon beigelii. These opportunistic fungal pathogens are associated with various localized and disseminated clinical syndromes, and with substantial morbidity and mortality. These established, invasive mycoses, particularly in bone marrow transplant recipients, are the focus of this discussion.
Insights
Invasive fungal infections are rising, especially in immunocompromised patients. Emerging fungal pathogens, beyond Candida and Aspergillus, pose significant risks in bone marrow transplant recipients.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Invasive fungal infections (IFIs) show a steady 2-decade increase, particularly in immunocompromised individuals.
- Candida albicans and Aspergillus fumigatus are traditional pathogens in bone marrow transplant (BMT) recipients.
- Shifting pathogen profiles include non-albicans Candida species and non-fumigatus Aspergillus species.
Purpose of the Study:
- To discuss established and emerging opportunistic fungal pathogens in BMT recipients.
- To highlight the clinical significance and epidemiology of these IFIs.
- To focus on mycoses in the context of bone marrow transplantation.
Main Methods:
- Literature review and clinical case analysis.
- Epidemiological trend analysis of IFIs.
- Pathogen identification and characterization.
Main Results:
- Emergence of uncommon fungal pathogens like Blastoschizomyces capitatus, Fusarium, Malassezia furfur, and Trichosporon beigelii.
- These fungi cause diverse localized and disseminated syndromes.
- Significant morbidity and mortality associated with these opportunistic infections.
Conclusions:
- The spectrum of fungal pathogens causing IFIs in BMT recipients is expanding.
- Awareness of emerging and uncommon fungi is crucial for timely diagnosis and treatment.
- Effective management strategies are needed to combat rising IFI rates in vulnerable populations.