Volatile Organic Compounds: Upcoming Role in Diagnosis of Invasive Mould Infections
AbstractPurpose of ReviewBreath testing for fungal respiratory infections has great promise as samples can be obtained by non-invasive, repeatable techniques that can be done on a wide range of patients including children, the confused and from those in the intensive care unit (ICU). We have reviewed progress toward development of test applicable to clinical practice.Recent FindingsMany volatile organic compounds (VOCs) have been identified, especially from key pathogens such asAspergillus fumigatus, but very few clinical trials have been performed. The most convincing of these demonstrated thatAspergillus species could be...
Source: Current Fungal Infection Reports - July 24, 2017 Category: Infectious Diseases Source Type: research
Untargeted Antifungal Treatment Strategies for Invasive Candidiasis in Non-neutropenic Critically Ill Patients: Current Evidence and Insights
AbstractPurpose of ReviewThe purpose of this study was to provide an overview and insights on important new concepts on untargeted antifungal treatment strategies, namely prophylaxis pre-emptive and empiric treatments for the management of invasive candidiasis (IC) in non-neutropenic critically ill patients.Recent FindingsRecently, clinical practice guidelines provided recommendation for the management of IC. However, results from recent trials and systematic reviews questioned the effect of untargeted antifungal treatment strategies, especially in terms of survival benefits in non-neutropenic patients, even with septic sh...
Source: Current Fungal Infection Reports - July 22, 2017 Category: Infectious Diseases Source Type: research
Fungal Leukonychia and Melanonychia: a Review
AbstractFungal leukonychia is a common condition in immunosuppressed patients; the most common clinical forms are white superficial and proximal white superficial onychomycosis. It is frequently associated withTrichophyton mentagrophytes var.interdigitale and withTrichophyton rubrum. The diagnosis can be easily made by direct examination and culture. Fungal melanonychia is the nail plate pigmentation caused by fungal infections. The most frequently isolated fungi isT. rubrum and melanized molds likeNeoscytalidium dimidiatum. The main differential diagnosis is malignant melanoma, although other causes include subungueal hem...
Source: Current Fungal Infection Reports - July 19, 2017 Category: Infectious Diseases Source Type: research
Antifungal Susceptibility Testing of Candida and Cryptococcus Species and Mechanisms of Resistance: Implications for Clinical Laboratories
AbstractPurpose of ReviewResistance to antifungal drugs amongstCandida species is a growing concern, and azole resistance may be emerging inCryptococcus species. This review provides a contemporary perspective, relevant to the clinical mycology laboratory, of antifungal susceptibility testing of these fungi, focussing on the challenges of phenotypic and genotypic methodologies to detect drug resistance.Recent FindingsStandardised CLSI and EUCAST broth microdilution (BMD) susceptibility testing methods are the benchmark to determine clinical breakpoints (CBPs) and/or epidemiological cut-off values (ECVs) MICs forCandida and...
Source: Current Fungal Infection Reports - July 8, 2017 Category: Infectious Diseases Source Type: research
Fungal Paronychia. Clinical, Diagnosis and Treatment Aspects
AbstractPurpose of ReviewThe purpose of this study is to recognize and expand the knowledge of mycotic paronychia as a variable clinical condition due to various predisposing factors and multiple fungal organisms.Recent FindingsCandida-associated mycotic paronychia is common but other non-dermatophyte molds, such asFusarium, are identified as potential agents of paronychia and onychomycosis.SummaryMycotic paronychia is characterized by inflammation of the proximal or lateral nail folds caused by certain fungi. Mycological analysis is necessary to identify the causal agent and prescribe an appropriate treatment. Further stu...
Source: Current Fungal Infection Reports - July 8, 2017 Category: Infectious Diseases Source Type: research
Onychomycosis Laboratory Diagnosis: Review
AbstractPurpose of ReviewOnychomycosis is a growing global health problem. Proper diagnosis is important in order to avoid the risks of unnecessary treatments. This review summarizes the laboratory techniques currently available for the diagnosis of onychomycosis with the advantages and disadvantages of each test.Recent FindingsResearch is underway to prove the clinical utility of other diagnostic techniques such as PAS-stained nail biopsies and molecular tests as viable alternatives for the diagnosis of onychomycosis with promissory results.SummaryDermoscopy can be helpful to differentiate onychomycosis from traumatic ony...
Source: Current Fungal Infection Reports - July 8, 2017 Category: Infectious Diseases Source Type: research
Update on Therapeutic Drug Monitoring of Antifungals for the Prophylaxis and Treatment of Invasive Fungal Infections
AbstractPurpose of ReviewCertain antifungals used as therapy for invasive fungal disease, including the extended-spectrum triazoles, may be limited by variable pharmacokinetics and drug interactions. This is especially important when drug exposure, as measured by trough concentrations, may be linked to either efficacy or toxicity. We review the rationale, indications, and controversies in TDM of antifungals.Recent FindingsThe monitoring of voriconazole drug levels is often practiced in patients that receive this triazole based on clinical data. Posaconazole delayed-release tablets achieve higher drug exposure more consiste...
Source: Current Fungal Infection Reports - July 1, 2017 Category: Infectious Diseases Source Type: research
Sporotrichosis: Update on Diagnostic Techniques
AbstractPurpose of ReviewSporotrichosis, the disease caused bySporothrix spp, ranges from subcutaneous infections to the severe disseminated or invasive diseases. The taxonomy ofSporothrix has been revised. The subcutaneous disease is suspected easily, but the extra-cutaneous disease is diagnosed by chance or with high suspicion. This review provides the overview of currently available diagnostic techniques.Recent FindingEnzyme-linked immunosorbent assay (ELISA) or latex agglutination test with partially purified antigens helps in the diagnosis of extra-cutaneous sporotrichosis. Molecular methods have been used for the ide...
Source: Current Fungal Infection Reports - June 30, 2017 Category: Infectious Diseases Source Type: research
Pathogenesis of Invasive Pulmonary Aspergillosis in Transplant Recipients
AbstractPurpose of ReviewTransplant patients are at high risk for invasive pulmonary aspergillosis, and the associated mortality is high. The purpose of this study is to review the pathogenesis of invasive pulmonary aspergillosis (IPA) in transplant patients.Recent FindingsThe pathogenesis of aspergillosis is multifactorial and results from a complex interplay between the pathogen and host. It is well recognized thatAspergillus causes IPA in immunocompromised patients. Recent studies have shown thatAspergillus might also cause diseases likely attributed to an unmodulated immune response in certain transplant recipients suc...
Source: Current Fungal Infection Reports - June 27, 2017 Category: Infectious Diseases Source Type: research
The Efficacy and Safety of Systemic Antifungals in Children ’s Onychomycosis
AbstractPurpose of ReviewThere are few reports about onychomycosis in children with inconclusive results about the better and safer option. We have observed and reported on the literature a significant increase in the prevalence of onychomycosis in this age group.Recent FindingsFungal infections, especially on the nails, are common health diseases with increasing prevalence according to age; however, it is rare in the pediatric population, except in patients with Down syndrome and primary and secondary immunodeficiency.SummaryIn this review, we focused on characteristics of children ’s onychomycosis as well as the effica...
Source: Current Fungal Infection Reports - June 23, 2017 Category: Infectious Diseases Source Type: research
Treatment of the Midwestern Endemic Mycoses, Blastomycosis and Histoplasmosis
AbstractPurpose of ReviewThe purpose of this review is to assess the recommended treatment regimens for the major endemic mycoses, histoplasmosis and blastomycosis, which occur in the Midwestern USA and to provide information about the use of newer antifungal agents for these diseases.Recent FindingsThe basic approach to treatment of histoplasmosis and blastomycosis outlined in the IDSA Guidelines is helpful in managing these diseases. However, changes since these guidelines were published provide safer and better tolerated treatment regimens. Prolonged treatment with amphotericin B is rarely required, and lipid formulatio...
Source: Current Fungal Infection Reports - June 21, 2017 Category: Infectious Diseases Source Type: research
Harnessing Whole Genome Sequencing in Medical Mycology
AbstractPurpose of ReviewComparative genome sequencing studies of human fungal pathogens enable identification of genes and variants associated with virulence and drug resistance. This review describes current approaches, resources, and advances in applying whole genome sequencing to study clinically important fungal pathogens.Recent FindingsGenomes for some important fungal pathogens were only recently assembled, revealing gene family expansions in many species and extreme gene loss in one obligate species. The scale and scope of species sequenced is rapidly expanding, leveraging technological advances to assemble and ann...
Source: Current Fungal Infection Reports - June 9, 2017 Category: Infectious Diseases Source Type: research
Progress in the Diagnosis of Invasive Fungal Disease in Children
AbstractPurpose of ReviewThis review summarizes the fungal diagnostic measures currently available for use in paediatric patients at high risk for developing invasive fungal disease (IFD) and those suspected of having an IFD. The clinical utility of each test is described based on reported performances of individual tests in specific paediatric populations.Recent FindingsAvailable studies in the paediatric population are scarce and are characterized by a huge heterogeneity in underlying diseases (e.g. different risk for IFD), different study objectives and management strategies (screening versus diagnostic) used.SummaryA f...
Source: Current Fungal Infection Reports - May 2, 2017 Category: Infectious Diseases Source Type: research
Lateral Flow Assays for the Diagnosis of Invasive Aspergillosis: Current Status
AbstractPurpose of ReviewDiagnosis during early stages of invasive aspergillosis (IA) and targeted antifungal treatment has the potential to improve survival significantly. Despite advances in the diagnostic arsenal, invasive mold infections remain difficult to diagnose —especially at early stages before typical radiological signs develop. Varying availability and time-to-results are important limitations of current approved biomarkers and molecular assays for diagnosis of IA. Here, we will give an update on theAspergillus-specific lateral-flow device (LFD) test. We further review promising findings on feasibility of poi...
Source: Current Fungal Infection Reports - April 29, 2017 Category: Infectious Diseases Source Type: research
MALDI-TOF MS and Filamentous Fungal Identification: A Success Story?
AbstractPurpose of ReviewThe diagnosis of invasive fungal disease remains challenging in the clinical laboratory. In this paper, the use of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) for the identification of filamentous fungi as well as its application for antifungal resistance testing and strain typing is evaluated.Recent FindingsMost studies report very high accuracy for the identification of filamentous fungi by MALDI-TOF MS. Its cost effectiveness, short analysis time, and low error rate and the fact that it can also discriminate between closely related and cryptic spec...
Source: Current Fungal Infection Reports - April 24, 2017 Category: Infectious Diseases Source Type: research
