Article

Invasive mold infections: recent advances in management approaches.

Division of Infectious Diseases, Department of Internal Medicine, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA.
Leukemia & lymphoma (impact factor: 2.4). 04/2009; 50(5):703-15. DOI:10.1080/10428190902777434 pp.703-15
Source: PubMed

ABSTRACT An increasing number of patients are undergoing transplantation procedures or receiving aggressive immunosuppression and chemotherapy. The growing population of immunocompromised hosts has led to a rise in the prevalence of invasive fungal infections (IFIs) due to yeasts and molds. Recent trends suggest that patients are acquiring infections with non-Candida albicans species, non-Aspergillus fumigatus species and non-Aspergillus molds such as Fusarium species, Scedosporium species and Zygomycetes. There are also a few reports of resistance to standard azole and echinocandin therapy, and some Aspergillus (A. ustus, A. terreus) and Scedosporium species are inherently resistant to polyenes. Early diagnosis and appropriate treatment of mold infections are important to improve outcomes. The use of high-resolution computed tomography scanning and new diagnostic tools such as the galactomannan and beta-glucan tests help early detection of IFIs. With the changing epidemiology of fungal infections and emergence of rare pathogens, and with the availability of a larger number of antifungal drugs, new management strategies are evolving to effectively treat invasive mold infections.

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Keywords

aggressive immunosuppression
 
antifungal drugs
 
Aspergillus
 
beta-glucan tests
 
changing epidemiology
 
echinocandin therapy
 
fungal infections
 
Fusarium species
 
growing population
 
high-resolution computed tomography scanning
 
invasive fungal infections
 
larger number
 
new diagnostic tools
 
new management strategies
 
non-Aspergillus molds
 
prevalence
 
rare pathogens
 
Recent trends
 
reports
 
standard azole
 

Pranatharthi Chandrasekar