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Efficient Method for Imaging Murine Lungs that Preserves Spatial Dynamics of Fungal Spores in the Airways
Published on: December 13, 2024
Fungal respiratory disease
1Medical Mycology Laboratory, Shanghai Jiaotong University Xinhua Hospital, Shanghai, China. zryaosmu@sohu.com
Purpose Of Review:
Fungal respiratory disease is associated with a high mortality in immunocompromised patients. This review aims to describe the recent advances in the aetiology, clinical presentation, diagnosis and management of fungal respiratory disease.
Recent Findings:
Invasive aspergillosis is an uncommon complication of hematopoietic stem cell transplants and solid-organ transplants but continues to be associated with poor outcome. Isolation of Aspergillus spp. from respiratory samples preceded acute rejection in lung-transplantation recipients. Molecular typing suggested that there was a very weak correlation between the environmental and patient isolates of Aspergillus fumigatus in invasive pulmonary aspergillosis. Serological and molecular detection of Aspergillus antigens or fungal DNA may improve the diagnosis of pulmonary aspergillosis, but the sensitivity is variable and more studies are needed. Voriconazole and caspofungin are choice to Aspergillus and Candida infection, especially to azole-resistant Candida spp. Treatment combining amphotericin B preparations, early surgical resection of infected tissue and discontinuation of immunosuppressive treatment may improve prognosis of mucormycosis.
Summary:
Invasive filamentaous fungal infections of lung remain important causes of death in immunocompromised patients. Development of new early diagnostic tools and well-designed multicenter evaluations of diagnostic methods and therapeutic regimens available at present are the important work in the next 2-3 years.
Insights
Fungal respiratory diseases pose a significant threat to immunocompromised patients. Advances in diagnosis and treatment, including new antifungal agents and diagnostic tools, are crucial for improving outcomes in invasive fungal infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Background:
- Fungal respiratory diseases are a leading cause of mortality in immunocompromised individuals.
- Invasive fungal infections, such as aspergillosis and mucormycosis, present significant challenges in transplant recipients.
Purpose of the Study:
- To review recent advancements in the etiology, clinical presentation, diagnosis, and management of fungal respiratory diseases.
- To highlight the challenges and future directions in combating these infections.
Main Methods:
- Literature review of recent studies on fungal respiratory diseases.
- Analysis of diagnostic methods, including serological and molecular detection.
- Evaluation of current and emerging therapeutic strategies.
Main Results:
- Invasive aspergillosis in transplant patients is associated with poor outcomes.
- Molecular diagnostics show variable sensitivity for pulmonary aspergillosis.
- Newer antifungals like voriconazole and caspofungin are effective, particularly against resistant strains.
- Combination therapy and prompt intervention improve mucormycosis prognosis.
Conclusions:
- Invasive filamentous fungal infections remain a critical cause of death in immunocompromised patients.
- Development of novel early diagnostic tools is essential.
- Multicenter evaluations of diagnostic methods and therapeutic regimens are needed.
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