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Lung infections due to emerging fungal pathogens
Francisco J Machiavello Roman1, Lauren Pischel1, Marwan M Azar2
1Department of Medicine, Section of Infectious Diseases.
Purpose Of Review:
This review highlights the epidemiology, pathogenesis and clinical management of pulmonary infections caused by emerging fungal organisms.
Recent Findings:
Emerging fungal infections have arisen as a result of population and environmental changes. An enlarging pool of immunocompromised hosts on triazole antifungal prophylaxis has led to an increased incidence of non- Aspergillus molds, such as Fusarium , Scedosporium and Lomentospora spp. Advances in diagnostic capabilities led to the identification of the Emergomyces genus and non- dermatitidis Blastomyces species, which have a significant disease burden in Africa and the Middle East. Climate change has contributed to changing the distribution of previously confined endemic mycoses, like coccidioidomycosis and talaromycosis. These emerging organisms pose important diagnostic and therapeutic challenges.
Summary:
Newly recognized pathogenic fungi and established endemic mycoses with expanding geographic boundaries have become important agents of pulmonary disease. There is a dearth of clinical evidence on the appropriate management of these infections.
Insights
Emerging fungal pulmonary infections are increasing due to environmental and population shifts, posing diagnostic and treatment challenges. This review covers epidemiology, pathogenesis, and management of these difficult-to-treat fungal diseases.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonary Medicine
Background:
- Rising incidence of pulmonary fungal infections driven by increased immunocompromised populations and environmental changes.
- Emergence of non-Aspergillus molds (e.g., Fusarium, Scedosporium) due to widespread triazole antifungal prophylaxis.
- Identification of new fungal genera (Emergomyces) and geographical expansion of endemic mycoses (e.g., coccidioidomycosis) linked to climate change.
Approach:
- Comprehensive review of current literature on emerging fungal pulmonary pathogens.
- Analysis of epidemiological trends, pathogenesis mechanisms, and diagnostic advancements.
- Evaluation of clinical management strategies and identification of therapeutic challenges.
Key Points:
- Non-Aspergillus molds and newly identified fungal species represent significant threats.
- Climate change is altering the geographic distribution of endemic fungal diseases.
- Diagnostic and therapeutic interventions for these emerging infections are often limited by scarce clinical evidence.
Conclusions:
- Emerging fungal pathogens and expanding endemic mycoses are critical causes of pulmonary disease.
- There is an urgent need for robust clinical evidence to guide the management of these infections.
- Addressing these challenges requires multidisciplinary approaches in diagnostics and therapeutics.
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