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Rare and emerging fungal pulmonary infections

Jay B Varkey1, John R Perfect

  • 1Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. j.varkey@duke.edu

Seminars in Respiratory and Critical Care Medicine
|March 28, 2008
PubMed

Insights

Serious fungal infections are rising, especially in immunocompromised individuals. Diagnosis requires organism identification, and treatment may involve new antifungals and immune system support.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunocompromised Hosts

Background:

  • Increasing incidence and diversity of serious fungal infections.
  • Severely immunocompromised individuals are highly susceptible to environmental molds and yeasts.
  • Clinical presentations vary from colonization to invasive disease.

Purpose of the Study:

  • To highlight the challenges in diagnosing and treating rare and emerging fungal infections.
  • To emphasize the need for accurate identification and appropriate therapeutic strategies.

Main Methods:

  • Diagnosis relies on isolation and identification of fungi, often requiring histopathology.
  • Radiological and serological diagnostic methods are limited.
  • In vitro susceptibility testing is crucial due to emerging resistance patterns.

Main Results:

  • Rare fungi are frequently isolated from the respiratory tract in immunosuppressed patients.
  • Many emerging molds exhibit resistance to traditional antifungal agents like older azoles and amphotericin B.
  • Histopathology is essential to distinguish colonization from invasive fungal infections.

Conclusions:

  • Successful treatment of rare fungal infections may necessitate surgical intervention and immune reconstitution.
  • Newer triazoles, including voriconazole and posaconazole, show promise in treating infections caused by emerging molds.
  • Multifaceted approaches are critical for managing these challenging infections in vulnerable populations.

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