Aspergillus to Zygomycetes: Causes, Risk Factors, Prevention, and Treatment of Invasive Fungal Infections

  title={Aspergillus to Zygomycetes: Causes, Risk Factors, Prevention, and Treatment of Invasive Fungal Infections},
  author={Oliver A. Cornely},
  • O. Cornely
  • Published 19 July 2008
  • Biology, Medicine
  • Infection
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality, particularly in patients with underlying risk factors (e.g., neutropenia, cancer chemotherapy, transplantation, AIDS). Although Candida species remain a relevant cause of IFI, other organisms (particularly moulds) have become increasingly prevalent. In particular, Aspergillus species are the leading cause of mould infections although other moulds including Fusarium species and Zygomycetes are increasing in… 
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The second-generation triazoles, voriconazole and posaconazole, have found important roles in the management of invasive fungal infections in high-risk patients and are well absorbed, but considerable intra- and interpatient pharmacokinetic variability has raised the question of therapeutic drug monitoring.
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The aim of this article is to discuss certain aspects of the approach to invasive fungal diseases due to uncommon yeasts in patients with hematological malignancies, focusing on epidemiology, diagnosis, treatment outcomes and the role of novel antifungal drugs.
[Identification of filamentous fungi isolated from clinical samples by two different methods and their susceptibility results].
The identification of filamentous fungi such as Aspergillus and Fusarium spp.
Diagnosis and Treatment of Invasive Fungal Infections Focus on Liposomal Amphotericin B
The present paper reviews the epidemiology and diagnosis of IFIs and focuses primarily on the role of liposomal amphotericin B in this setting and the main recommendations put forth by expert societies and groups.
DNA-Based Detection of Human Pathogenic Fungi: Dermatophytes, Opportunists, and Causative Agents of Deep Mycoses
The contribution of DNA-based techniques to the identification of clinically important fungi such as Aspergillus, Blastomyces, Candida, Coccidioides, Cryptococcus, Dematiaceous fungi, Fusarium, Histoplasma, Trichosporon, Zygomycetes, and Dermatophytes is focused on.
Development, clinical utility, and place in therapy of posaconazole for prevention and treatment of invasive fungal infections
Clinical data have demonstrated the clinical utility of posaconazole against many therapy-refractory pathogens, and it appears poised to become a prominent therapeutic modality for the prophylaxis and management of various fungal infections among high-risk patients.
Evaluating the role of prophylaxis in the management of invasive fungal infections in patients with hematologic malignancy
The epidemiology of the most important fungal pathogens, identifies high‐risk patient groups and risk factors associated with IFI, and critically evaluates the advantages and disadvantages of available diagnostic tests and treatment strategies and the rationale for antifungal prophylaxis are evaluated.
Species-Specific Identification of a Wide Range of Clinically Relevant Fungal Pathogens by Use of Luminex xMAP Technology
The observations demonstrate that the Luminex-based technology presented permits rapid and reliable identification of fungal species and may therefore be instrumental in routine clinical diagnostics.


Zygomycosis: the re-emerging fungal infection
The clinical spectrum of zygomycosis is now broader, and it can be difficult to distinguish between mucormycosis and enthomophthoramycosis, both of which can manifest as disease ranging from a superficial infection to an angioinvasive infection with high mortality.
Recent advances in antifungal pharmacotherapy for invasive fungal infections
The introduction of the echinocandins has invigorated the discussion about combination antifungal therapy and they are assuming important roles in the pharmacotherapy of invasive fungal infections in seriously ill and complex patients.
Voriconazole: therapeutic review of a new azole antifungal
  • R. Herbrecht
  • Biology, Medicine
    Expert review of anti-infective therapy
  • 2004
The new triazole antifungal, voriconazole (Vfend®, Pfizer Ltd), was developed for the treatment of life-threateningFungal infections in immunocompromised patients and had excellent clinical efficacy in patients with fluconazole-sensitive and -resistant candida infection, aspergillosis, and various refractory fungal infections.
Zygomycetes in human disease.
The Mucorales are associated with angioinvasive disease, often leading to thrombosis, infarction of involved tissues, and tissue destruction mediated by a number of fungal proteases, lipases, and mycotoxins.
The Emerging Role of Fusarium Infections in Patients with Cancer
Fusarium species could play a role in producing myelosuppression and fungal cultures are required to differentiate it from the more commonly encountered Aspergillus species.
Current treatment strategies for disseminated candidiasis.
  • B. SpellbergS. FillerJ. Edwards
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2006
Fluconazole is the agent of choice for the empirical treatment of disseminated candidiasis in nonneutropenic, hemodynamically stable patients, unless a patient is suspected to be infected with an azole-resistant species (i.e., Candida glabrata or Candida krusei).
Breakthrough trichosporonosis in patients with acute myeloid leukemia receiving micafungin
Two cases of Trichosporon asahii fungemia in patients with acute myeloblastic leukemia (AML), both of whom received micafungin as a single agent for anti-fungal prophylaxis are reported.
Prevention of fungal infections in the immunocompromised host.
This strategy has the potential to provide patients likely to suffer severe fungal infection the benefits of antifungal agents while avoiding the negative aspects (toxicity, cost and risk of resistance) in patients at low risk for these infections.
Fungal Infections in Patients With Neutropenia
Fluconazole is appropriate for antifungal prophylaxis and should be offered to patients with prolonged neutropenia, such as high-risk patients with leukaemia undergoing remission induction or consolidation therapy and high- risk stem cell transplant recipients.
Taxonomy, biology, and clinical aspects of Fusarium species
Foreign-body-associated fusarial infection such as keratitis in contact lens wearers, onychomycosis, skin infections, and disseminated multiorgan infections are discussed and the implications for the association of the carcinogens, fumonisins, produced by Fusarium moniliforme and other FUSarium species with human diseases are discussed.