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Phaeohyphomycosis in China.

Yun He1,2,3, Hai-Lin Zheng1,2, Huan Mei1,2

  • 1Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China.

Frontiers in Cellular and Infection Microbiology
|June 30, 2022
PubMed
Summary
This summary is machine-generated.

Phaeohyphomycosis (PHM) cases increased due to COVID-19 and immunosuppression. This study provides a new classification system to improve diagnosis and treatment of this challenging fungal infection.

Keywords:
clinical featuresdiagnosisdrug sensitiveepidemiologymelanized fungiphaeohyphomycosisrisk factorstreatment strategy

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Dermatology

Background:

  • Increased incidence of phaeohyphomycosis (PHM) linked to COVID-19 and immunosuppressive therapies.
  • Melanized fungi infections pose diagnostic and treatment challenges.
  • Need for better understanding of PHM clinical features in China.

Purpose of the Study:

  • To comprehensively analyze clinical features of PHM in China over 35 years.
  • To establish a practical classification and grading system for PHM lesions.
  • To guide treatment strategies and improve patient prognosis.

Main Methods:

  • Systematic review of 174 proven PHM cases from 1987-2021 (Chinese and English literature).
  • Detailed analysis of epidemiology, fungal species, MIC values, clinical presentations, treatments, and outcomes.
  • Development of accurate classification definitions and severity grading.

Main Results:

  • High mortality rates for cerebral (55%), disseminated (36%), and pulmonary (25%) PHM.
  • Significant morbidity including disability, disfigurement, and blindness in 19% of patients.
  • Overall misdiagnosis rate of 74%; moderate to severe rashes in 82% of subcutaneous cases, predominantly on head/face.

Conclusions:

  • Proposed classification system is practical and easily popularized.
  • No significant differences in cure or mortality rates across lesion grades.
  • Severe rashes associated with longer treatment courses and lower effective rates.