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Frequency, diagnosis and management of fungal respiratory infections

Gemma E Hayes1, David W Denning

  • 1Department of Respiratory Medicine, Plymouth Hospitals NHS Trust, Derriford Hospital, Derriford Road, Crownhill, Plymouth, UK.

Current Opinion in Pulmonary Medicine
|February 16, 2013
PubMed
Abstract

Insights

Recent advances in fungal respiratory infections show improved diagnostics and management for Aspergillus, Pneumocystis, and Cryptococcus. Early detection and new treatments are crucial, but challenges like azole resistance persist.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Fungal respiratory infections pose a significant global health burden.
  • Key pathogens include Aspergillus, Pneumocystis jirovecii, and Cryptococcus.
  • Advances in understanding epidemiology, diagnostics, and management are critical.

Purpose of the Study:

  • To review recent key advances in fungal respiratory infections.
  • To focus on developments concerning Aspergillus, Pneumocystis, and Cryptococcus.
  • To highlight progress in epidemiology, diagnostics, and patient management.

Main Methods:

  • Literature review of recent studies on fungal respiratory infections.
  • Analysis of epidemiological data, diagnostic techniques, and therapeutic strategies.
  • Focus on specific pathogens: Aspergillus, Pneumocystis, and Cryptococcus.

Main Results:

  • Chronic pulmonary aspergillosis has a high burden and is often underdiagnosed; new treatments are emerging.
  • Pneumocystis jirovecii exhibits airborne transmission, necessitating isolation and potentially identifying colonized individuals.
  • Early detection of Cryptococcus antigenaemia in HIV patients can prevent meningitis; antigen and PCR tests for Aspergillus are more sensitive.
  • Increasing azole resistance in Aspergillus fumigatus across Europe is a growing concern.

Conclusions:

  • The field of fungal respiratory infections is rapidly evolving with significant recent advances.
  • Isolation and segregation are recommended for patients with Pneumocystis infections.
  • Further research is needed to determine the full burden of Aspergillus disease and combat azole resistance.

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