A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
Year: 2017
Type: article
Study design: Observational Study
Abstract: 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.
Source: Open Forum Infectious Diseases
DOI: 10.1093/ofid/ofx200
Authors: Sanjay G Revankar, John W Baddley, Sharon C -A Chen, Carol A Kauffman, Monica Slavin, Jose A Vazquez, Carlos Seas, Michele I Morris, M Hong Nguyen, Shmuel Shoham, George R Thompson, Barbara D Alexander, Jacques Simkins, Luis Ostrosky-Zeichner, Kathleen Mullane, George Alangaden, David R Andes, Oliver A Cornely, Kerstin Wahlers, Shawn R Lockhart, Peter G Pappas
Institutions: Wayne State University, University of Alabama at Birmingham, Birmingham VA Medical Center, The University of Sydney, Westmead Hospital, University of Michigan, VA Ann Arbor Healthcare System, Michigan Medicine, Melbourne Health, Augusta University, Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, University of Miami, University of Pittsburgh, Johns Hopkins University, University of California, Davis, Duke Medical Center, The University of Texas Health Science Center at Houston, University of Chicago, Henry Ford Health, University of Wisconsin–Madison, University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, Klinikum Oldenburg, Centers for Disease Control and Prevention
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2756890849