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Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
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Fungal Group Zygomycota

Zygomycota, previously classified as a distinct fungal group, are primarily terrestrial, saprophytic molds that play a crucial role as decomposers. Recent phylogenetic studies have revealed that these fungi are now divided into two major clades — Mucoromycota, which includes many symbiotic species, and Zoopagomycota, which primarily consists of parasitic and pathogenic fungi. These groups exhibit distinct ecological roles and reproductive strategies while sharing key structural and...
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Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
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Candidiasis

Candidiasis is a fungal infection caused by opportunistic species of Candida. It can affect various anatomical sites, including the skin, oral cavity, nails, and genitourinary tract. Among its forms, vaginal candidiasis is the most common type of mucosal infection. It typically results from the overgrowth of Candida albicans in the vaginal mucosa. Under normal conditions, C. albicans exists as a commensal organism within the vaginal microbiota, regulated by the dominance of lactobacilli, which...
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Skin Diseases and Disorders

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Curcuminoid-Mediated Antimicrobial Photodynamic Therapy on a Murine Model of Oral Candidiasis
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How I treat mucormycosis.

Dimitrios P Kontoyiannis1, Russell E Lewis

  • 1Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. dkontoyi@mdanderson.org

Blood
|May 31, 2011
PubMed
Summary

Invasive mucormycosis in hematologic malignancy patients remains deadly, with few survival improvements. Early recognition, aggressive treatment, and individualized prophylaxis are crucial for improving outcomes in these immunocompromised individuals.

Area of Science:

  • Mycology
  • Hematology
  • Infectious Diseases

Background:

  • Invasive mucormycosis (IM) has a poor prognosis in hematologic malignancy patients, with high mortality rates persisting over the last decade.
  • Unlike invasive aspergillosis, significant survival improvements for IM have not been observed in this vulnerable population.

Purpose of the Study:

  • To highlight subtle clinical and radiographic signs of IM for early hematologist recognition.
  • To outline aggressive, timely treatment strategies to limit fatal infection spread.
  • To discuss individualized care, prophylaxis, and antifungal options for IM in immunocompromised patients.

Main Methods:

  • Review of clinical and radiographic presentations of invasive mucormycosis in hematology patients.
  • Discussion of treatment approaches, including multidisciplinary care and decision-making.

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  • Analysis of antifungal agents (amphotericin B, posaconazole) for IM and prophylaxis.

    • Main Results:

    • Early recognition and prompt, aggressive treatment can improve survival odds for IM in hematology patients.
    • Individualized treatment and secondary prophylaxis are essential, especially for persistently immunosuppressed patients.
    • Posaconazole offers a viable option for prolonged prophylaxis, but therapeutic drug monitoring may be necessary.

    Conclusions:

    • Improving survival in hematologic malignancy patients with IM requires early detection and integrated, individualized management.
    • Aggressive treatment and strategic use of antifungals like amphotericin B and posaconazole are key.
    • Careful consideration of prophylaxis, including drug level monitoring for posaconazole, is vital to prevent recurrence.