Fungal infections of the skin and soft tissue

Purpose of review This review aims to update on recent findings about epidemiology, risk factors and therapeutic options for fungi causing skin and soft tissue infections. The latest data on emerging antifungal resistance are also discussed. Recent findings In parallel with increased use of immunosuppression, the incidence of fungal infections is also on rise. This increase involves not only systemic infections but also infections with primary and secondary skin involvement. Antifungal resistance has become a major issue and covers several fungal pathogens including dermatophytes, Candida spp. and, Aspergillus fumigatus. Multidisciplinary usage of newly targeted, immunomodulatory therapies may predispose patients to have fungal infections through mimicking an immunosuppressed status caused by genetic factors or the disease itself. Nonimmunosupressed patients, although less frequently than those with immunosuppression may also be vulnerable. Summary Physicians should be aware about skin and soft tissue findings related with systemic or locally occuring mycosis. Emerging antifungal resistance may hamper the success of the treatment. Antifungal susceptibility testing is advisable wherever available and particularly when a disseminated fungal infection is present.
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

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Conclusion: Endogenous endophthalmitis is a sight threatening condition associated with high mortality particularly when caused by Aspergillus spp. in immunocompromised patients. Contrary to the prior published reports of endogenous endophthalmitis outside India, we found an equal distribution of fungal and bacterial organisms among our cases, with predominance of Aspergillus among fungal isolates and Gram-positive organism among bacteria. Fungal infections, especially with Aspergillus spp., resulted in poor visual and survival outcome.
Source: Indian Journal of Ophthalmology - Category: Opthalmology Authors: Source Type: research
Authors: Kelly BT, Pennington KM, Limper AH Abstract Introduction: Fungal infections are increasingly encountered in clinical practice due to more favorable environmental conditions and increasing prevalence of immunocompromised individuals. The diagnostic approach for many fungal pathogens continues to evolve. Herein, we outline available diagnostic tests for the most common fungal infections with a focus on recent advances and future directions.Areas covered: We discuss the diagnostic testing methods for angioinvasive molds (Aspergillus spp. and Mucor spp.), invasive yeast (Candida spp. and Cryptococcus sp.), Pne...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
Authors: Papachristou SG, Iosifidis E, Sipsas NV, Gamaletsou MN, Walsh TJ, Roilides E Abstract Introduction: Osteoarticular fungal infections (OAFIs) complicate the clinical course of high-risk patients, including immunosuppressed individuals. Their management, however, despite being intricate, is governed by evidence arising from sub-optimal quality research, such as case series. Guidelines are scarce and when present result in recommendations based on low quality evidence. Furthermore, the differences between the management of immunocompromised and immunocompetent patients are not distinct. This is a narrative re...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
AbstractPurpose of ReviewThis review summarizes current treatment options for echinocandin-resistantCandida spp. (ERC) and azole-resistantAspergillus fumigatus (ARAF), emphasizing recent in vitro/in vivo data, clinical reports, and consensus statements.Recent FindingsAdvances in ERC and ARAF treatment are limited to specific antifungal combinations and dose optimization but remain reliant on amphotericin products. Although novel antifungals may provide breakthroughs in the treatment of resistant fungi, these agents are not yet available. Early identification and appropriate treatment remain a paramount, albeit elusive, tas...
Source: Current Fungal Infection Reports - Category: Infectious Diseases Source Type: research
Authors: Hatinguais R, Willment JA, Brown GD Abstract Fungi are opportunistic pathogens that infect immunocompromised patients and are responsible for an estimated 1.5 million deaths every year. The antifungal innate immune response is mediated through the recognition of pathogen-associated molecular patterns (PAMPs) by the host's pattern recognition receptors (PRRs). PRRs are immune receptors that ensure the internalisation and the killing of fungal pathogens. They also mount the inflammatory response, which contributes to initiate and polarise the adaptive response, controlled by lymphocytes. Both the innate and ...
Source: Current Topics in Microbiology and Immunology - Category: Microbiology Tags: Curr Top Microbiol Immunol Source Type: research
Hematopoietic cell transplantation (HCT) is associated with a high risk of invasive fungal infections (IFIs). Fluconazole is approved in the United States for Candida prophylaxis during HCT, but it does not provide coverage against molds [1]. Voriconazole, a broad-spectrum triazole active against Candida and Aspergillus species, has been increasingly used for antifungal prophylaxis in patients undergoing high-risk HCT, such as cord blood HCT and ex vivo T cell-depleted HCT recipients [2-4]. In a randomized trial of voriconazole versus fluconazole prophylaxis in standard-risk HCT recipients, the overall rates of IFI and fun...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Hematopoietic cell transplantation (HCT) is associated with a high risk of invasive fungal infections (IFI). Fluconazole is approved in the United States for Candida prophylaxis during HCT, but it does not provide coverage against molds [1]. Voriconazole, a broad-spectrum triazole active against Candida and Aspergillus species, has been increasingly used for antifungal prophylaxis for high risk HCT such as cord blood HCT and ex vivo T-cell depleted HCT recipients [2 –4]. In a randomized trial of voriconazole versus fluconazole prophylaxis in standard risk HCT recipients, the overall rates of IFI and fungal free survi...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
CONCLUSIONS: According to our experience, micafungin is an appropriate alternative for antifungal prophylaxis in patients undergoing an allo-HSCT, because its efficacy, its low profile of drug interactions and side-effects. PMID: 32056418 [PubMed - as supplied by publisher]
Source: Revista Espanola de Quimioterapia - Category: Drugs & Pharmacology Authors: Tags: Rev Esp Quimioter Source Type: research
Abstract We evaluated the activity of rezafungin and comparators using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods against worldwide collection of 2,205 invasive fungal isolates recovered from 2016-2018. Candida spp. (1,904 isolates; 6 species), Cryptococcus neoformans (73), Aspergillus fumigatus (183) and Aspergillus flavus (45) isolates were susceptibility (S) tested for rezafungin as well as the comparators caspofungin, anidulafungin, micafungin, and azoles. Interpretive criteria were applied following CLSI published clinical breakpoints (CBP) and epidemiological cutoff values...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
The incidence of invasive fungal infections (IFIs) has recently increased, and early and accurate diagnosis of IFIs is important for the rational selection of antifungal drugs with high efficacy. We developed a method for rapid and accurate clinical diagnosis of IFIs and provide a reference for personalized drug treatment. We designed and screened fungal internal transcribed spacer regions with universal primers and designed 8 TaqMan detection probes to establish a multi-channel real-time fluorescent polymerase chain reaction (PCR) melting curve analysis (MCA) method. The sensitivity, specificity, and reproducibility of t...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research
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