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Emerging fungal pathogens in patients with hematologic malignancies and marrow/stem-cell transplant recipients
Balkrishna N Jahagirdar1, Vicki A Morrison
1Section of Hematology, Oncology, and Transplantation, University of Minnesota, USA.
Abstract:
Fungal infections are a major cause of morbidity and mortality among patients with hematologic malignancies and recipients of bone-marrow/hematopoietic stem-cell transplants. Although Candida and Aspergillus species remain the most common fungal pathogens, multiple unusual fungal pathogens are being increasingly recognized as a cause of infection in these patients. Many of these rare fungal infections have a characteristic clinical disease spectrum. Early diagnosis and prompt treatment of these infections is the key to a successful outcome. In this article, we summarize the epidemiology, pathogenesis, clinical features, and approach to the management of infections caused by Fusarium, Zygomycetes, Scedosporium, Trichosporon, Malassezia, Alternaria, Paecilomyces, and Penicillium.
Insights
Rare fungal infections pose significant risks for immunocompromised patients, including those with hematologic malignancies and stem-cell transplant recipients. This review details the epidemiology, clinical features, and management of infections caused by unusual fungal pathogens.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hematology
Background:
- Fungal infections are a significant cause of morbidity and mortality in immunocompromised patients, particularly those with hematologic malignancies and hematopoietic stem-cell transplant (HSCT) recipients.
- While Candida and Aspergillus are common, infections by unusual fungal pathogens are increasingly recognized in these vulnerable populations.
Purpose of the Study:
- To summarize the epidemiology, pathogenesis, clinical features, and management strategies for infections caused by a range of uncommon fungal pathogens.
- To highlight the importance of early diagnosis and prompt treatment for successful outcomes.
Main Methods:
- Review of current literature on fungal infections in immunocompromised hosts.
- Synthesis of information on epidemiology, pathogenesis, clinical presentations, and treatment approaches for specific rare fungal genera.
Main Results:
- Unusual fungal pathogens like Fusarium, Zygomycetes, Scedosporium, Trichosporon, Malassezia, Alternaria, Paecilomyces, and Penicillium cause distinct clinical syndromes.
- These infections require timely diagnosis and specific management due to their potential severity.
Conclusions:
- Recognizing the spectrum of disease caused by rare fungi is crucial for effective management in high-risk patient groups.
- Prompt diagnosis and targeted therapy are essential for improving outcomes in patients with these invasive fungal infections.