Current antifungal treatment of fusariosis

Area of Science:

• Medical Mycology
• Infectious Diseases

Background:

• * Fusarium species are significant plant pathogens and soil inhabitants, increasingly recognized for causing a wide range of human infections.
• * Fusariosis ranks as the second most common mould infection, with Fusarium keratitis being a prevalent implantation infection in immunocompetent individuals.

Purpose of the Study:

• * To review the clinical significance of Fusarium infections in humans.
• * To discuss current and emerging treatment strategies for fusariosis, particularly in the context of antifungal resistance.

Main Methods:

• * Literature review of Fusarium infections and their management.
• * Analysis of in vitro and in vivo antifungal activity data.
• * Examination of treatment outcomes for various forms of fusariosis.

Main Results:

• * Natamycin and voriconazole are key treatments for Fusarium keratitis.
• * Terbinafine, voriconazole, and itraconazole are used for onychomycosis, with successful treatment possible despite high MICs.
• * Disseminated Fusarium infections are rising in severely immunocompromised patients, exhibiting significant intrinsic resistance to antifungals.

Conclusions:

• * Fusarium infections pose a considerable threat, especially disseminated forms in immunocompromised hosts.
• * Intrinsic antifungal resistance in Fusarium species contributes to high mortality rates.
• * Management requires prompt diagnosis, supportive care (e.g., neutropenia recovery), and appropriate antifungal therapy, often involving voriconazole or amphotericin B.