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Treatment options in emerging mold infections
Patricia Muñoz1, Jesús Guinea, Emilio Bouza
1Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Calle del Doctor Esquerdo, 46, 28007 Madrid, Spain. pmunoz@micro.hggm.es
Current Infectious Disease Reports
|October 24, 2008
Summary
Emerging fungal infections caused by Zygomycetes, Fusarium, and Scedosporium species in immunocompromised patients show poor response to antifungals. Treatment requires surgical debridement and systemic antifungals like amphotericin B, with neutropenia recovery being key.
Area of Science:
- Mycology
- Infectious Diseases
- Immunocompromised Host
Background:
- Zygomycetes, Fusarium spp., and Scedosporium spp. are increasingly recognized as causes of invasive fungal infections (IFIs).
- These IFIs disproportionately affect severely immunocompromised patients.
- A common characteristic of these infections is a poor clinical response to standard antifungal therapies.
Purpose of the Study:
- To review the current understanding of IFIs caused by less common fungi.
- To highlight challenges in treatment and management strategies.
- To emphasize the importance of combined therapeutic approaches.
Main Methods:
- Literature review focusing on Zygomycetes, Fusarium spp., and Scedosporium spp. as pathogens.
- Analysis of clinical response to various antifungal treatments.
- Evaluation of prognostic factors for patient outcomes.
Main Results:
- Infections are often airborne or result from trauma.
- These fungi exhibit resistance to certain common antifungal agents.
- Amphotericin B remains a primary treatment option due to limited experience with newer agents.
Conclusions:
- Combined therapy of surgical debridement and systemic antifungals is recommended for immunocompromised patients.
- Recovery from neutropenia is the most significant predictor of a favorable outcome.
- Further research, including randomized clinical trials, is needed to optimize treatment strategies for these emerging fungal infections.
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