A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases

Details

• Alternative Title:
  Open Forum Infect Dis
• Personal Author:
  Revankar, Sanjay G ; Baddley, John W ; Chen, Sharon C -A ; Kauffman, Carol A ; Slavin, Monica ; Vazquez, Jose A ; Seas, Carlos ; Morris, Michele I ; Nguyen, M Hong ; Shoham, Shmuel ; Thompson, George R ; Alexander, Barbara D ; Simkins, Jacques ; Ostrosky-Zeichner, Luis ; Mullane, Kathleen ; Alangaden, George ; Andes, David R ; Cornely, Oliver A ; Wahlers, Kerstin ; Lockhart, Shawn R ; Pappas, Peter G
• Description:
  Background
  
  Phaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the goal of improving the recognition and management of these infections.
  
  Methods
  
  Patients from 18 sites in 3 countries were enrolled from 2009–2015. Cases were categorized as local superficial, local deep (pulmonary, sinus, osteoarticular infections), and disseminated infections. End points were clinical response (partial and complete) and all-cause mortality at 30 days and end of follow-up.
  
  Results
  
  Of 99 patients, 32 had local superficial infection, 41 had local deep infection, and 26 had disseminated infection. The most common risk factors were corticosteroids, solid organ transplantation, malignancy, and diabetes. Cultures were positive in 98% of cases. All-cause mortality was 16% at 30 days and 33% at end of follow-up, and 18 of 26 (69%) with dissemination died. Itraconazole was most commonly used for local infections, and voriconazole was used for more severe infections, often in combination with terbinafine or amphotericin B.
  
  Conclusions
  
  Phaeohyphomycosis is an increasingly recognized infection. Culture remains the most frequently used diagnostic method. Triazoles are currently the drugs of choice, often combined with other agents. Further studies are needed to develop optimal therapies for disseminated infections.
  
  
• Subjects:
  Mycoses Phaeohyphomycosis
• Source:
  Open Forum Infect Dis. 2017; 4(4).
• Pubmed ID:
  29766015
• Pubmed Central ID:
  PMC5946886
• Document Type:
  Journal Article
• Volume:
  4
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:48fe88e0e3baafddc8367126205eaa2655508dddf9b525168f9964535c5e6186
• Download URL:
  https://stacks.cdc.gov/view/cdc/55637/cdc_55637_DS1.pdf
• File Type:
  [PDF - 156.85 KB ]