Contributor(s)Division of Infectious Diseases, University of Michigan Medical School
Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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AbstractThis review details some of the advances that have been made in the recent decade in the diagnosis, treatment and epidemiology of pulmonary fungal infections. These advances have occurred because of increasing knowledge regarding the fungal genome, better understanding of the structures of the fungal cell wall and cell membrane and the use of molecular epidemiological techniques. The clinical implications of these advances are more rapid diagnosis and more effective and less toxic antifungal agents. For example, the diagnosis of invasive pulmonary aspergillosis, as well as histoplasmosis and blastomycosis, has improved with the use of easily performed antigen detection systems in serum and bronchoalveolar lavage fluid. Treatment of angioinvasive moulds has improved with the introduction of the new azoles, voriconazole and posaconazole that have broad antifungal activity. Amphotericin B is less frequently used, and when used is often given as lipid formulation to decrease toxicity. The newest agents, the echinocandins, are especially safe as they interfere with the metabolism of the fungal cell wall, a structure not shared with humans cells. Epidemiological advances include the description of the emergence of Cryptococcus gattii in North America and the increase in pulmonary mucormycosis and pneumonia due to Fusarium and Scedosporium species in transplant recipients and patients with haematological malignancies. The emergence of azole resistance among Aspergillus species is especially worrisome and is likely related to increased azole use for treatment of patients, but also to agricultural use of azoles as fungicides in certain countries.
Smith, Jeannina A. ; Kauffman, Carol A. (2012). "Pulmonary fungal infections." Respirology 17(6). <http://hdl.handle.net/2027.42/92435>
Saccente M, Woods GL. Clinical and laboratory update on blastomycosis. Clin. Microbiol. Rev. 2010; 23: 367 ??? 81.
Lemos LB, Baliga M, Guo M. Acute respiratory distress syndrome and blastomycosis: presentation of nine cases and review of the literature. Ann. Diagn. Pathol. 2001; 5: 1 ??? 9.
Martynowicz MA, Prakash UB. Pulmonary blastomycosis: an appraisal of diagnostic techniques. Chest 2002; 121: 768 ??? 73.
Durkin M, Witt J, Lemonte A et???al. Antigen assay with the potential to aid in diagnosis of blastomycosis. J. Clin. Microbiol. 2004; 42: 4873 ??? 5.
Bariola JR, Hage CA, Durkin M et???al. Detection of Blastomyces dermatitidis antigen in patients with newly diagnosed blastomycosis. Diagn. Microbiol. Infect. Dis. 2011; 69: 187 ??? 91.
Carlos WG, Rose AS, Wheat LJ et???al. Blastomycosis in Indiana: digging up more cases. Chest 2010; 138: 1377 ??? 82.
Babady NE, Buckwalter SP, Hall L et???al. Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real???time PCR. J. Clin. Microbiol. 2011; 49: 3204 ??? 8.
Chapman SW, Dismukes WE, Proia LA et???al. Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 2008; 46: 1801 ??? 12.
Lahm T, Neese S, Thornburg AT et???al. Corticosteroids for blastomycosis???induced ARDS; a report of two patients and review of the literature. Chest 2008; 133: 1478 ??? 80.
Kauffman CA. Histoplasmosis: clinical and laboratory update. Clin. Microbiol. Rev. 2007; 20: 115 ??? 32.
Wheat LJ, Conces D, Allen SD et???al. Pulmonary histoplasmosis syndromes: recognition, diagnosis, and management. Sem. Respir. Crit. Care Med. 2004; 25: 129 ??? 44.
Wheat LJ. Approach to the diagnosis of the endemic mycoses. Clin. Chest Med. 2009; 30: 379 ??? 89.
Swartzentruber S, Rhodes L, Kurkjian K et???al. Diagnosis of acute pulmonary histoplasmosis by antigen detection. Clin. Infect. Dis. 2009; 49: 1878 ??? 82.
Hage CA, Davis TE, Fuller D et???al. Diagnosis of histoplasmosis by antigen detection in BAL fluid. Chest 2010; 137: 623 ??? 8.
Hage CA, Ribes JA, Wengenack NL et???al. A multicenter evaluation of tests for diagnosis of histoplasmosis. Clin. Infect. Dis. 2011; 53: 448 ??? 54.
Wheat LJ, Freifeld AG, Kleiman MB et???al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 2007; 45: 807 ??? 25.
Freifeld A, Proia L, Andes D et???al. Voriconazole use for endemic fungal infections. Antimicrob. Agents Chemother. 2009; 53: 1648 ??? 51.
Doyle TP, Loyd JE, Robbins IM. Percutaneous pulmonary artery and vein stenting: a novel treatment for mediastinal fibrosis. Am. J. Respir. Crit. Care Med. 2001; 164: 657 ??? 60.
Ampel NM. Coccidioidomycosis. In: Kauffman CA, Pappas PG, Sobel JD et???al. (eds) Essentials of Clinical Mycology, 2nd edn. Springer, New York, 2011; 349 ??? 66.
Anstead GM, Graybill JR. Coccidioidomycosis. Infect. Dis. Clin. North Am. 2006; 20: 621 ??? 43.
Pappagianis D. Current status of serologic studies in coccidioidomycosis. Curr. Fungal Infect. Rep. 2007; 1: 129 ??? 34.
Durkin M, Connolly P, Kuberski T et???al. Diagnosis of coccidioidomycosis with use of the Coccidioides antigen enzyme immunoassay. Clin. Infect. Dis. 2008; 47: e69 ??? 73.
Galgiani JN, Ampel NM, Blair JE et???al. Coccidioidomycosis. Clin. Infect. Dis. 2005; 41: 1217 ??? 23.
Kim MM, Vikram HR, Kusne S et???al. Treatment of refractory coccidioidomycosis with voriconazole or posaconazole. Clin. Infect. Dis. 2011; 53: 1060 ??? 6.
Kauffman CA, Nicolasora NP. Epidemiology of invasive pulmonary aspergillosis. In: Pasqualotto AC (ed.) Aspergillosis: From Diagnosis to Prevention. Springer, New York, 2009; 329 ??? 44.
Pasqualotto AC. Differences in pathogenicity and clinical syndromes due to Aspergillus fumigatus and Aspergillus flavus. Med. Mycol. 2009; 47: S261 ??? 70.
van der Linden JWM, Warris A, Verweij PE. Aspergillus species intrinsically resistant to antifungal agents. Med. Mycol. 2011; 49: S82 ??? 9.
Cramer RA, Rivera A, Hohl T. Immune responses against Aspergillus fumigatus: what have we learned? Curr. Opin. Infect. Dis. 2011; 24: 315 ??? 22.
Singh N, Husain S. AST Infectious Diseases Community of Practice. Invasive aspergillosis in solid organ transplant recipients. Am. J. Transplant. 2009; 9 (Suppl. 4 ): S180 ??? 91.
Ben???Ami R, Lewis R, Kontoyiannis DP. Invasive mould infections in the setting of hematopoietic cell transplantation: current trends and new challenges. Curr. Opin. Infect. Dis. 2009; 22: 376 ??? 84.
Georgiadou SP, Sipsas NV, Marom EM et???al. The diagnostic value of halo and reversed halo signs for invasive mold infections in compromised hosts. Clin. Infect. Dis. 2011; 52: 1144 ??? 55.
Park SY, Kim SH, Choi SH et???al. Clinical and radiological features of invasive pulmonary aspergillosis in transplant recipients and neutropenic patients. Transpl. Infect. Dis. 2010; 12: 309 ??? 15.
Segal BH. Aspergillosis. N. Engl. J. Med. 2009; 360: 1870 ??? 84.
De Pauw B, Walsh TJ, Donnelly JP et???al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin. Infect. Dis. 2008; 46: 1813 ??? 21.
Maertens J, Theunissen K, Lodewyck T et???al. Advances in the serological diagnosis of invasive Aspergillus infections in patients with haematological disorders. Mycoses 2007; 50 (Suppl. 1 ): 2 ??? 17.
Pfeiffer CD, Fine JP, Safdar N. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta???analysis. Clin. Infect. Dis. 2006; 42: 1417 ??? 27.
Miceli MH, Grazziutti ML, Woods G et???al. Strong correlation between serum Aspergillus galactomannan index and outcome of aspergillosis in patients with hematological cancer: clinical and research implications. Clin. Infect. Dis. 2008; 46: 1412 ??? 22.
Husain S, Kwak EJ, Obman A et???al. Prospective assessment of Platelia Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients. Am. J. Transplant. 2004; 4: 796 ??? 802.
Clancy CJ, Jaber RA, Leather HL et???al. Bronchoalveolar lavage galactomannan in diagnosis of invasive pulmonary aspergillosis among solid???organ transplant recipients. J. Clin. Microbiol. 2007; 45: 1759 ??? 65.
Husain S, Clancy CJ, Nguyen MH et???al. Performance characteristics of the platelia Aspergillus enzyme immunoassay for detection of Aspergillus galactomannan antigen in bronchoalveolar lavage fluid. Clin. Vaccine Immunol. 2008; 15: 1760 ??? 3.
Guo YL, Chen YQ, Wang K et???al. Accuracy of bronchoalveolar lavage galactomannan in diagnosing invasive aspergillosis: a bivariate meta???analysis and systematic review. Chest 2010; 138: 817 ??? 24.
Maertens J, Maertens V, Theunissen K et???al. Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases. Clin. Infect. Dis. 2009; 49: 1688 ??? 93.
Mengoli C, Cruciani M, Barnes RA et???al. Use of PCR for diagnosis of invasive aspergillosis: systematic review and meta???analysis. Lancet Infect. Dis. 2009; 9: 89 ??? 96.
White LP, Perry MD, Moody A et???al. Evaluation of analytical and preliminary clinical performance of Myconostica MycAssay Aspergillus when testing serum specimens for diagnosis of invasive aspergillosis. J. Clin. Microbiol. 2011; 49: 2169 ??? 74.
Luong M???L, Clancy CJ, Vadnerkar A et???al. Comparison of an Aspergillus real???time polymerase chain reaction assay with galactomannan testing of bronchoalveolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in lung transplant recipients. Clin. Infect. Dis. 2011; 52: 1218 ??? 26.
Torelli R, Sanguinetti M, Moody A et???al. Diagnosis of invasive aspergillosis by a commercial real???time PCR assay for Aspergillus DNA in bronchoalveolar lavage fluid samples from high???risk patients compared to a galactomannan assay. J. Clin. Microbiol. 2011; 49: 4273 ??? 78.
Herbrecht R, Denning DW, Patterson TF et???al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N. Engl. J. Med. 2002; 347: 408 ??? 15.
Walsh TJ, Anaissie EJ, Denning DW et???al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin. Infect. Dis. 2008; 46: 327 ??? 60.
Limper AH, Knox KS, Sarosi GA et???al. An official American Thoracic Society statement: treatment of fungal infections in adult pulmonary and critical care patients. Am. J. Respir. Crit. Care Med. 2011; 183: 96 ??? 128.
Walsh TJ, Raad I, Patterson TF et???al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin. Infect. Dis. 2007; 44: 2 ??? 12.
Verweij PE, Snelders E, Kema GHJ et???al. Azole resistance in Aspergillus fumigatus: a side effect of environmental fungicide use. Lancet Infect. Dis. 2009; 9: 789 ??? 95.
Howard SJ, Arendrup MC. Acquired antifungal drug resistance in Aspergillus fumigatus: epidemiology and detection. Med. Mycol. 2011; 49: S90 ??? 5.
Bowyer P, Moore CB, Rautemaa R et???al. Azole antifungal resistance today: focus on aspergillosis. Curr. Infect. Dis. Rep. 2011; 13: 485 ??? 91.
van der Linden JWM, Snelders E, Kampinga GA et???al. Clinical implications of azole resistance in Aspergillus fumigatus, the Netherlands, 2007???2009. Emerg. Infect. Dis. 2011; 17: 1846 ??? 54.
Kontoyiannis DP, Marr KA, Park BJ et???al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001???2006: overview of the Transplant???Associated Infection Surveillance Network (TRANSNET) database. Clin. Infect. Dis. 2010; 50: 1091 ??? 100.
Roden MM, Zaoutis TE, Buchanan WL et???al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin. Infect. Dis. 2005; 41: 634 ??? 53.
Kontoyiannis DP, Lionakis MS, Lewis RE et???al. Zygomycosis in a tertiary???care cancer center in the era of Aspergillus??? active antifungal therapy: a case???control observational study of 27 recent cases. J. Infect. Dis. 2005; 191: 1350 ??? 60.
Trifilio S, Singhal S, Williams S et???al. Breakthrough fungal infections after allogeneic hematopoietic stem cell transplantation in patients on prophylactic voriconazole. Bone Marrow Transplant. 2007; 40: 451 ??? 6.
Chamilos G, Marom EM, Lewis RE et???al. Predictors of pulmonary zygomycosis versus invasive aspergillosis in patients with cancer. Clin. Infect. Dis. 2005; 41: 60 ??? 6.
Hammond SP, Baden LR, Marty FM. Mortality in hematologic malignancy and hematopoietic stem cell transplant patients with mucormycosis, 2001 to 2009. Antimicrob. Agents Chemother. 2011; 55: 5018 ??? 21.
Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B???based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin. Infect. Dis. 2008; 47: 503 ??? 9.
Ibrahim AS, Edwards JE Jr, Filler SG et???al. Mucormycosis and entomophthoramycosis (zygomycosis). In: Kauffman CA, Pappas PG, Sobel JD et???al. (eds) Essentials of Clinical Mycology, 2nd edn. Springer, New York, 2011; 265 ??? 80.
Bialek R, Konrad F, Kern J et???al. PCR???based identification and discrimination of agents of mucormycosis and aspergillosis in paraffin wax embedded tissue. J. Clin. Pathol. 2005; 58: 1180 ??? 4.
Hammond SP, Bialek R, Milner DA et???al. Molecular methods to improve the diagnosis and identification of mucormycosis. J. Clin. Microbiol. 2011; 49: 2151 ??? 3.
Kontoyiannis DP, Lewis R. How I treat mucormycosis. Blood 2011; 118: 1216 ??? 24.
Lewis RE, Albert ND, Liao G et???al. Comparative pharmacodynamics of amphotericin B lipid complex and liposomal amphotericin B in a murine model of pulmonary mucormycosis. Antimicrob. Agents Chemother. 2010; 54: 1298 ??? 304.
Torres HA, Hachem RY, Chemaly RF et???al. Posaconazole: a broad spectrum triazole agent. Lancet Infect. Dis. 2005; 5: 775 ??? 85.
Spellberg B, Walsh TJ, Kontoyiannis DP et???al. Recent advances in the management of mucormycosis: from bench to bedside. Clin. Infect. Dis. 2009; 48: 1743 ??? 51.
Torres HA, Kontoyiannis DP. Hyalohyphomycoses (hyaline molds). In: Kauffman CA, Pappas PG, Sobel JD et???al. (eds) Essentials of Clinical Mycology, 2nd edn. Springer, New York, 2011; 281 ??? 304.
Gilgado F, Cano J, Gen?? J et???al. Different virulence of the species of the Pseudallescheria boydii complex. Med. Mycol. 2009; 47: 371 ??? 4.
Rodriquez???Tudela JL, Berenguer J, Guarro J et???al. Epidemiology and outcome of Scedosporium prolificans infection: a review of 162 cases. Med. Mycol. 2009; 47: 359 ??? 70.
Husain S, Alexander B, Munoz P et???al. Opportunistic mycelial fungi in organ transplant recipients: emerging importance of non??? Aspergillus mycelial infections. Clin. Infect. Dis. 2003; 37: 221 ??? 9.
Nucci M, Marr KA, Queiroz???Telles F et???al. Fusarium infection in hematopoietic stem cell transplant recipients. Clin. Infect. Dis. 2004; 38: 1237 ??? 42.
Nucci M, Anaissie E. Fusarium infections in immunocompromised patients. Clin. Microbiol. Rev. 2007; 20: 697 ??? 704.
Nucci M, Anaissie E. Cutaneous infection by Fusarium species in healthy and immunocompromised hosts: implications for diagnosis and management. Clin. Infect. Dis. 2002; 35: 909 ??? 20.
Castelli MV, Buitrago MJ, Bernal???Martinez L et???al. Development and validation of a quantitative PCR assay for diagnosis of scedosporiosis. J. Clin. Microbiol. 2008; 46: 3412 ??? 6.
Hayden RT, Isotalo PA, Parrett T et???al. In situ hybridization for the differentiation of Aspergillus, Fusarium, and Pseudallescheri a species in tissue section. Diagn. Mol. Pathol. 2003; 12: 21 ??? 6.
Lortholary O, Obenga G, Biswas P et???al. International retrospective analysis of 73 cases of invasive fusariosis treated with voriconazole. Antimicrob. Agents Chemother. 2010; 54: 4446 ??? 50.
Raad II, Hachem RY, Herbrecht R et???al. Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions. Clin. Infect. Dis. 2006; 42: 1398 ??? 403.
Ho DY, Lee JD, Rosso F et???al. Treating disseminated fusariosis: amphotericin B, voriconazole, or both? Mycoses 2007; 50: 227 ??? 31.
Troke P, Aguirrebengoa K, Arteaga C et???al. Treatment of scedosporiosis with voriconazole: clinical experience with 107 patients. Antimicrob. Agents Chemother. 2008; 52: 1743 ??? 50.
Steinbach WJ, Perfect JR. Scedosporium species infections and treatments. J. Chemother. 2003; 15: 16 ??? 27.
Harris JR, Lockhart SR, Debess E et???al. Cryptococcus gattii in the United States: clinical aspects of infection with an emerging pathogen. Clin. Infect. Dis. 2011; 53: 1188 ??? 95.
Pappas PG, Perfect JR, Cloud GA et???al. Cryptococcosis in human immunodeficiency virus???negative patients in the era of effective azole therapy. Clin. Infect. Dis. 2001; 33: 690 ??? 9.
Singh N, Dromer F, Perfect JR et???al. Cryptococcosis in solid organ transplant recipients: current state of the science. Clin. Infect. Dis. 2011; 47: 1321 ??? 7.
Chang WC, Tzao C, Hsu HH et???al. Pulmonary cryptococcosis: comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients. Chest 2006; 129: 333 ??? 40.
Baddley JW, Perfect JR, Oster RA et???al. Pulmonary cryptococcosis in patients without HV infection: factors associated with disseminated disease. Eur. J. Clin. Microbiol. Infect. Dis. 2008; 27: 937 ??? 43.
Singh N, Forrest G, Infectious AST. Diseases Community of Practice. Cryptococcosis in solid organ transplant recipients. Am. J. Transplant. 2009; 9 (Suppl. 4 ): S192 ??? 8.
Perfect JR, Dismukes WE, Dromer F et???al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 2010; 50: 291 ??? 322.
Smith JA, Kauffman CA. Blastomycosis. Proc. Am. Thorac. Soc. 2010; 7: 173 ??? 80.