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Phaeohyphomycotic infections in solid organ transplant patients

Julia B Garcia-Diaz1, Katherine Baumgarten

  • 1Ochsner Clinic Foundation, Section of Infectious Diseases, Department of Medicine, Tulane University, New Orleans, LA 70121, USA. jgarcia-diaz@ochsner.org

Seminars in Respiratory Infections
|December 24, 2002
PubMed

Insights

Phaeohyphomycoses, fungal infections from dark fungi, increasingly affect immunocompromised individuals, particularly transplant recipients. Treatment combines surgery with variable antifungal therapies, requiring sensitivity testing for effective management.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunocompromised Host Research

Background:

  • Phaeohyphomycoses are infections caused by darkly pigmented fungi.
  • These infections are rare in immunocompetent individuals but increasingly reported in immunocompromised hosts, especially solid organ transplant recipients.
  • Clinical presentations vary from superficial to disseminated infections.

Purpose of the Study:

  • To review the epidemiology, clinical manifestations, and treatment of phaeohyphomycoses.
  • To highlight the challenges in managing these infections in immunocompromised patients.

Main Methods:

  • Literature review of phaeohyphomycoses cases and treatment outcomes.
  • Analysis of common causative agents like Exophiala spp. and Alternaria spp.

Main Results:

  • Exophiala and Alternaria species are the predominant causes of phaeohyphomycoses.
  • Treatment strategies depend on infection severity, ranging from surgical excision and itraconazole for subcutaneous lesions to amphotericin B for systemic or CNS involvement.
  • Antifungal sensitivity testing is crucial due to variable fungal responses.

Conclusions:

  • Phaeohyphomycoses pose a significant threat to immunocompromised individuals.
  • A combination of surgical intervention and targeted antifungal therapy, guided by sensitivity testing, is essential for successful management.
  • Emerging azole antifungals may offer alternative treatment options.

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