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Non-Aspergillus fungal infections in chronic granulomatous disease

John Dotis1, Zoe Dorothea Pana, Emmanuel Roilides

  • 11st Department of Pediatrics, Aristotle University School of Medicine, Hippokration General Hospital, Thessaloniki, Greece.

Mycoses
|February 2, 2013
PubMed

Insights

Chronic granulomatous disease (CGD) patients face rare fungal infections beyond Aspergillus. This review highlights Rhizopus and Trichosporon as key pathogens, emphasizing improved clinical awareness for better outcomes.

Area of Science:

  • Immunology
  • Mycology
  • Infectious Diseases

Background:

  • Chronic granulomatous disease (CGD) is a primary immunodeficiency hindering phagocyte killing of catalase-positive organisms.
  • While Aspergillus spp. are common fungal pathogens in CGD, rare fungal infections pose significant threats.

Purpose of the Study:

  • To systematically review and analyze all published cases of non-Aspergillus fungal infections in CGD patients.
  • To identify prevalent non-Aspergillus fungal pathogens, affected organs, treatment strategies, and outcomes in CGD.

Main Methods:

  • Systematic literature review of English-language publications.
  • Analysis of 68 cases of non-Aspergillus fungal infections in 65 CGD patients.
  • Data extraction on patient demographics, fungal species, affected organs, treatments, and mortality.

Main Results:

  • Rhizopus spp. and Trichosporon spp. were the most prevalent non-Aspergillus pathogens (9 cases each).
  • Pulmonary involvement was most common (69.9%).
  • Amphotericin B formulations were the most frequent first-line monotherapy (45.6%), with an overall mortality rate of 26.2%.

Conclusions:

  • Non-Aspergillus fungal infections are significant in CGD patients and require clinical consideration.
  • Awareness of emerging fungal pathogens and their epidemiology is crucial for optimizing antifungal treatment.
  • Improved knowledge can enhance patient outcomes in CGD.

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