scholarly journals Emerging mould infections: Get prepared to meet unexpected fungi in your patient

2019 ◽  
Author(s):  
Sarah Dellière ◽  
Olga Rivero-Menendez ◽  
Cécile Gautier ◽  
Dea Garcia-Hermoso ◽  
Ana Alastruey-Izquierdo ◽  
...  
Keyword(s):  
Fungal Pathogens ◽  
Immunosuppressive Drugs ◽  
Modern Medicine ◽  
Fungal Diseases ◽  
Emerging Pathogens ◽  
Delay In Diagnosis ◽  
Invasive Fungal Diseases ◽  
Fungal Organisms ◽  
Emerging Issues ◽  
Antigen Tests

Abstract Invasive fungal diseases are increasing issues in modern medicine, where the human immunodeficiency virus (HIV) pandemic and the wider use of immunosuppressive drugs generate an ever-growing number of immunocompromised patients with an increased susceptibility to uncommon fungal pathogens. In the past decade, new species have been reported as being responsible for disseminated and invasive fungal diseases in humans. Among them, the following genera are rare but seem emerging issues: Scopulariopsis, Hormographiella, Emergomyces, Westerdykella, Trametes, Actinomucor, Saksenaea, Apophysomyces, and Rhytidhysteron. Delay in diagnosis, which is often the case in these infections, jeopardizes patients’ prognosis and leads to increased mortality. Here we summarize the clinical and biological presentation and the key features to identify these emerging pathogens and we discuss the available antifungal classes to treat them. We focused on Pubmed to recover extensively reported human invasive cases and articles regarding the nine previously cited fungal organisms. Information concerning patient background, macroscopic and microscopic description and pictures of these fungal organisms, histological features in tissues, findings with commonly used antigen tests in practice, and hints on potential efficient antifungal classes were gathered. This review's purpose is to help clinical microbiologists and physicians to suspect, identify, diagnose, and treat newly encountered fungi in hospital settings.

scholarly journals Isavuconazole for the treatment of patients with invasive fungal diseases involving the central nervous system

2019 ◽  
Vol 58 (4) ◽  
pp. 417-424 ◽  
Author(s):  
Stefan Schwartz ◽  
Oliver A Cornely ◽  
Kamal Hamed ◽  
Francisco M Marty ◽  
Johan Maertens ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Clinical Trials ◽  
Nervous System ◽  
Fungal Pathogens ◽  
Hematologic Malignancies ◽  
Fungal Diseases ◽  
Phase Iii ◽  
Clinical Activity ◽  
Invasive Fungal Diseases ◽  
Cryptococcus Species

Abstract The incidence of invasive fungal diseases (IFDs) with central nervous system (CNS) involvement is increasing due to the rising numbers of immunocompromised individuals, such as patients receiving chemotherapy, transplantation procedures, or immune-modulating therapies. CNS IFDs cause significant morbidity and mortality, and treatments are complicated by difficulties in identifying fungal pathogens and delivering antifungal agents to the CNS. Isavuconazole is a novel triazole with broad-spectrum activity that has shown good blood–brain barrier penetration in animal models. We present a retrospective analysis of isavuconazole in the treatment of patients with CNS IFDs and who either participated in the phase III VITAL or SECURE clinical trials, or were included in a named-patient program. A total of 36 patients were identified, including 27 patients from the clinical trials. Of these patients, 47.2% had hematologic malignancies, while 13.9% had no identifiable underlying conditions. Mucorales, Aspergillus species, and Cryptococcus species accounted for 30.6%, 22.2%, and 13.9% of infections, respectively. The overall survival rate was 80.6% at day 42 and 69.4% at day 84, and at the end of treatment, a complete or partial clinical response was achieved in 58.3% of patients. Isavuconazole exhibited clinical activity in a variety of CNS IFDs.

scholarly journals Prospective Evaluation of Serum β-Glucan Testing in Patients With Probable or Proven Fungal Diseases

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Cécile Angebault ◽  
Fanny Lanternier ◽  
Frédéric Dalle ◽  
Cécile Schrimpf ◽  
Anne-Laure Roupie ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Clinical Suspicion ◽  
Fungal Diseases ◽  
Prospective Evaluation ◽  
Invasive Fungal Diseases ◽  
Undetectable Serum ◽  
Antifungal Use ◽  
Kinetics Of ◽  
Rule Out

Abstract Background.  Early diagnosis and treatment are crucial in invasive fungal diseases (IFD). Serum (1-3)-β-d-glucan (BG) is believed to be an early IFD marker, but its diagnostic performance has been ambiguous, with insufficient data regarding sensitivity at the time of IFD diagnosis (TOD) and according to outcome. Whether its clinical utility is equivalent for all types of IFD remains unknown. Methods.  We included 143 patients with proven or probable IFD (49 invasive candidiasis, 45 invasive aspergillosis [IA], and 49 rare IFD) and analyzed serum BG (Fungitell) at TOD and during treatment. Results.  (1-3)-β-d-glucan was undetectable at TOD in 36% and 48% of patients with candidemia and IA, respectively; there was no correlation between negative BG results at TOD and patients' characteristics, localization of infection, or prior antifungal use. Nevertheless, patients with candidemia due to Candida albicans were more likely to test positive for BG at TOD (odds ratio = 25.4, P = .01) than patients infected with other Candida species. In 70% of the patients with a follow-up, BG negativation occurred in >1 month for candidemia and >3 months for IA. A slower BG decrease in patients with candidemia was associated with deep-seated localizations (P = .04). Thirty-nine percent of patients with rare IFD had undetectable BG at TOD; nonetheless, all patients with chronic subcutaneous IFD tested positive at TOD. Conclusions.  Undetectable serum BG does not rule out an early IFD, when the clinical suspicion is high. After IFD diagnostic, kinetics of serum BG are difficult to relate to clinical outcome.

scholarly journals Use of Multimodality Imaging in Diagnosing Invasive Fungal Diseases of the Heart

2017 ◽  
Vol 10 (6) ◽  
Author(s):  
Ersilia M. DeFilippis ◽  
Sarah Cuddy ◽  
Carolyn Glass ◽  
Sarv Priya ◽  
Ayaz Aghayev ◽  
...  
Keyword(s):  
Multimodality Imaging ◽  
Fungal Diseases ◽  
Invasive Fungal Diseases

Fresh-cut apples: Challenges and opportunities for multi-disciplinary research

2006 ◽  
Vol 86 (Special Issue) ◽  
pp. 1361-1368 ◽  
Author(s):  
Peter M. A. Toivonen
Keyword(s):  
Value Chain ◽  
Fungal Pathogens ◽  
Value Added ◽  
Research Strategy ◽  
Production Costs ◽  
Food Microbiology ◽  
Research Activities ◽  
Industry Practice ◽  
Emerging Issues ◽  
Fresh Cut

The fresh-cut apple industry has recently become established in North America. The future looks very bright for this value-added fruit product, however its growth requires improvements in quality and reduction of production costs. The existing industry has grown from concept to reality in response to research activities in anti-browning dips, package technology, sensory analysis, postharvest physiology, postharvest pathology and food microbiology. Several examples of how these critical research inputs have impacted and continue to impact on the industry practice are discussed. The next generation of questions and challenges posed by the industry will require some new inputs. Research in several disciplines will be need accessed to resolve the emerging issues. Traditional breeding effort and/or molecular technologies will be needed to provide non-browning fruit, fruit with better processing characteristics such as small cores to reduce waste and improved flavour and nutrition retention after cutting. With new cultivars, further work will be required to understand the commercial handling of each, including selection of harvest maturity and optimization of storage protocols. Also, pre-harvest factors such as phosphorus nutrition will need to be investigated further in terms of their effects on fruit tissue and membrane stability. Management of fungal pathogens is a key issue that needs to be studied from the field through storage and after cutting and packaging of the sliced fruit. The very nature of fresh-cut fruit has and continues to require a coordinated multi-disciplinary research strategy. Key words: Value-chain, value-added, apples, fresh-cut, integrated research

scholarly journals The emergence of cereal fungal diseases and the incidence of leaf spot diseases in Finland

2008 ◽  
Vol 20 (1) ◽  
pp. 62 ◽  
Author(s):  
M. JALLI ◽  
P. LAITINEN ◽  
S. LATVALA
Keyword(s):  
Spring Wheat ◽  
Leaf Spot ◽  
Fungal Pathogens ◽  
Plant Pathogens ◽  
Field Survey ◽  
Fungal Diseases ◽  
Cochliobolus Sativus ◽  
Pyrenophora Tritici Repentis ◽  
Fungal Plant Pathogens ◽  
First Time

Fungal plant pathogens causing cereal diseases in Finland have been studied by a literature survey, and a field survey of cereal leaf spot diseases conducted in 2009. Fifty-seven cereal fungal diseases have been identified in Finland. The first available references on different cereal fungal pathogens were published in 1868 and the most recent reports are on the emergence of Ramularia collo-cygni and Fusarium langsethiae in 2001. The incidence of cereal leaf spot diseases has increased during the last 40 years. Based on the field survey done in 2009 in Finland, Pyrenophora teres was present in 86%, Cochliobolus sativus in 90% and Rhynchosporium secalis in 52% of the investigated barley fields. Mycosphaerella graminicola was identified for the first time in Finnish spring wheat fields, being present in 6% of the studied fields. Stagonospora nodorum was present in 98% and Pyrenophora tritici-repentis in 94% of spring wheat fields. Oat fields had the fewest fungal diseases. Pyrenophora chaetomioides was present in 63% and Cochliobolus sativus in 25% of the oat fields studied.;

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