1. Needles in a haystack: Extremely rare invasive fungal infections reported in FungiScopeⓇ—Global Registry for Emerging Fungal Infections
- Author
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Shruti Malik, Barbara Graf, Anupma Jyoti Kindo, Michele I. Morris, Carol A. Kauffman, Hamid Badali, Frédéric Janvier, Barbara D. Alexander, Lóránt Hatvani, Iker Falces-Romero, George Richard Thompson, Thomas P. Weber, Aamer Ikram, Georg Haerter, Mathias W. Pletz, Arunaloke Chakrabarti, Monica A. Slavin, Alessandro C. Pasqualotto, María Almagro-Molto, Sibylle C. Mellinghoff, Martha Avilés-Robles, Michaela Lackner, Mario Fernández-Ruiz, Melina Heinemann, Miguel Ángel Benítez-Peñuela, Lisa Meintker, Aleksandra Barac, Olaf Penack, Diana L. Pakstis, Zdeněk Ráčil, Nicolas Pichon, John W. Baddley, Jin Yu, Raoul Herbrecht, Martin Hoenigl, Jesús García-Martínez, Paul R. Ingram, Robert Krause, Cornelia Lass-Flörl, Shariq Haider, Barbora Weinbergerova, Carlos Seas, Jeffrey D. Jenks, Simone Cesaro, Vanda Chrenková, Luis Figueira, Donald C. Sheppard, Guillaume Desoubeaux, Galina Klyasova, Seda Yilmaz-Semerci, Vincent Marconi, Gloria M. González, Philipp Koehler, Donald C. Vinh, Eduardo Álvarez-Duarte, Atul Patel, Damien Dupont, José Yesid Rodríguez, Kenji Uno, Sanjay Mehta, Nicole Desbois-Nogard, Sandra Gräber, Jagdish Chander, Rodrigo Martino, Kathleen M. Mullane, Andrea Mocná, Yohann Le Govic, Mihai Mareș, Hilmar Wisplinghoff, Serkan Atıcı, Patricia Cornejo-Juárez, Jose A. Vazquez, Uluhan Sili, Jon Salmanton-García, Oliver A. Cornely, Nikolai Klimko, Sharon C.-A. Chen, Danila Seidel, Pamela Hartman, Me Linh Luong, Julio García-Rodríguez, Deniz Yilmaz-Karapinar, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), and Université d'Angers (UA)
- Subjects
0301 basic medicine ,Microbiology (medical) ,Mucorales ,Fusariosis ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,030106 microbiology ,Eurotiales ,yeast ,invasive fungal infection ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,invasive fungal infection, mold, yeast ,Acute leukemia ,biology ,business.industry ,Mortality rate ,mold ,Mucormycosis ,medicine.disease ,biology.organism_classification ,Dermatology ,3. Good health ,Infectious Diseases ,business - Abstract
Objectives Emerging invasive fungal infections (IFI) have become a notable challenge. Apart from the more frequently described fusariosis, lomentosporiosis, mucormycosis, scedosporiosis, and certain dematiaceae or yeasts, little is known about extremely rare IFI. Methods Extremely rare IFI collected in the FungiScopeⓇ registry were grouped as Dematiaceae, Hypocreales, Saccharomycetales, Eurotiales, Dermatomycetes, Agaricales, and Mucorales. Results Between 2003 and June 2019, 186 extremely rare IFI were documented in FungiScopeⓇ. Dematiaceae (35.5%), Hypocreales (23.1%), Mucorales (11.8%), and Saccharomycetales (11.3%) caused most IFI. Most patients had an underlying malignancy (38.7%) with acute leukemia accounting for 50% of cancers. Dissemination was observed in 26.9% of the patients. Complete or partial clinical response rate was 68.3%, being highest in Eurotiales (82.4%) and in Agaricales (80.0%). Overall mortality rate was 29.3%, ranging from 11.8% in Eurotiales to 50.0% in Mucorales. Conclusions Physicians are confronted with a complex variety of fungal pathogens, for which treatment recommendations are lacking and successful outcome might be incidental. Through an international consortium of physicians and scientists, these cases of extremely rare IFI can be collected to further investigate their epidemiology and eventually identify effective treatment regimens.
- Published
- 2020
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