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Therapy of infections caused by dematiaceous fungi

Sanjay G Revankar1

  • 1Dallas VA Medical Center, 4500 S. Lancaster Road, Dallas, TX 75216, USA. sanjay.revankar@med.va.gov

Expert Review of Anti-Infective Therapy
|August 19, 2005
PubMed

Insights

Dematiaceous fungi cause diverse infections, from local to disseminated disease in immunocompromised individuals. Melanin in their cell walls may be a virulence factor, and azole antifungals show consistent activity against these fungi.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Fungal Pathogenesis

Background:

  • Dematiaceous fungi cause a spectrum of clinical syndromes.
  • These fungi possess melanin in their cell walls, contributing to their dark pigmentation.
  • Melanin is a potential virulence factor in dematiaceous fungal infections.

Purpose of the Study:

  • To review the clinical significance of dematiaceous fungi.
  • To discuss the role of melanin in fungal virulence.
  • To outline current and potential future therapeutic strategies.

Main Methods:

  • Literature review of clinical syndromes associated with dematiaceous fungi.
  • Analysis of the role of fungal cell wall melanin in pathogenesis.
  • Evaluation of antifungal agents based on in vitro activity.

Main Results:

  • Infections range from localized traumatic to disseminated disease in immunocompromised hosts.
  • Melanin's presence is a defining characteristic and potential virulence determinant.
  • Azoles (itraconazole, voriconazole) exhibit consistent in vitro activity.

Conclusions:

  • Treatment strategies for dematiaceous fungal infections are syndrome-dependent.
  • Local infections may be managed with surgical excision.
  • Systemic infections are often challenging to treat, with azoles as a primary therapeutic option, and novel agents may emerge.

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