Clinical guidelines for fungal infections

* * * Last updated: November 2021 * * *

The documents linked below provide the most up-to-date recommendations compiled by committees of experts, based on scientific literature and research. Where no guidelines exist for a particular disease, comprehensive reviews are included which contain expert recommendations.

Country or region of publication is listed in square brackets.

Invasive infections

Infection or purpose Guidelines
Diagnosis

8th European Conference on Infections in Leukaemia (Groll et al, 2021) Guidelines for the diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or post-haematopoietic cell transplantation [Europe]

BSMM (Schelenz et al, 2015) Diagnosis of serious fungal diseases [UK]

ISHLT (Husain et al, 2015) Management of fungal infections in mechanical circulatory support and cardiothoracic organ transplant recipients [International]

Prophylaxis Annals of Hematology (Christopeit et al, 2021) Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation – update of the recommendations of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. [Germany]

 

RACP (Fleming et al, 2014) Prophylaxis in haematological malignancy and HSCT [Australasia]

General ECIL-6 (Tissot et al, 2017) Invasive candidiasis, aspergillosis and mucormycosis in leukaemia/HSCT [Europe]

 

SWAB practice guide (2017) Invasive fungal infections [Netherlands]

IDST (Ko et al, 2016) Antifungal agents in patients with hematological malignancies or HSCT [Taiwan]

CIFIWG (2020, 6th edition) Diagnosis and treatment of invasive fungal disease in patients with hematological disorders and cancers [China 中国]

Morgan et al (2016) Critical review of current clinical practice guidelines for antifungal therapy in paediatric haematology and oncology

Introduction to RACP guidelines (Slavin et al, 2014) [Australasia]
(Blyth et al, 2014) Invasive mould infections in haematological malignancy and HSCT
(Chen et al, 2014) Yeast infections in the haematology, oncology and intensive care setting
(Morrissey et al, 2014) Empiric and diagnostic‐driven antifungal treatment strategies in haematological malignancy
(Chau et al, 2014) Optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy
(Chang et al, 2014) Prevention and surveillance during hospital building works

Mycoses (Ruhnke et al, 2020) Treatment of invasive fungal diseases in cancer patients – Revised 2019 – Recommendations of the Infectious Diseases Working Party of the German Society of Hematology and Oncology. [Germany]

Journal of Clinical Oncology (Lehrnbecher et al, 2020) Clinical Practice Guideline for Systemic Antifungal Prophylaxis in Pediatric Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients. [International]

The Lancet (Hoenigl et al, 2021) Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International
Society for Human and Animal Mycology and the American Society for Microbiology. [Australasia]

Cryptococcosis JSMM (Izumikawa et al, 2019) Diagnosis and Treatment of Cryptococcosis [Japan]

 

IDSA (Perfect et al, 2010) Management of Cryptococcal Disease [USA]

WHO (2018) Diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children [International]

Clinicalinfo.HIV.gov (2015) Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV [USA]

SAHCS (Govender et al, 2013) Prevention, diagnosis and management of cryptococcal meningitis among HIV-infected persons [Southern Africa]

RACP (Chen et al, 2014) Yeast infections in the haematology, oncology and intensive care setting [Australasia]

Histoplasmosis IDSA (Wheat et al, 2007) Management of patients with Histoplasmosis [USA]

 

Clinicalinfo.HIV.gov (2015) Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV [USA]

Pan American Health Organization (2020) Diagnosing and managing disseminated histoplasmosis among people living with AIDS [Global]

Aspergillosis & Mucormycosis IDSA (Patterson et al, 2016) Diagnosis and Management of Aspergillosis [USA]

 

Expert panel (Al-Abdely et al, 2013) Treatment of invasive Aspergillus infections in adults [Middle East]

ESCMID-ECMM-ERS (Ullman et al, 2018) Diagnosis and management of Aspergillus diseases [Europe]

ECIL-6 (Tissot et al, 2017) Invasive candidiasis, aspergillosis and mucormycosis in leukaemia/HSCT[Europe]

AST-IDCOP (Husain et al, 2019) Invasive Aspergillosis in solid‐organ transplant recipients [USA]

Case series (Giudice et al, 2016) Rhinocerebral mucormycosis [Italy]

SWAB (2017) Netherlands *
* The SWAB guidelines are different from other invasive aspergillosis guidelines as they are the first for:
– ICU and severe influenza and IA
– Initial therapy for those areas with a high azole resistance frequency in A. fumigatus

The Lancet (Cornely et al, 2019) Global guideline for the diagnosis and management of mucormycosis. [Global]

Transplantation and Cellular Therapy (Dadwal et al, 2021) Management and Prevention of Aspergillosis in Hematopoietic Cell Transplantation Recipients. [North America]

Fungal rhinosinusitis ERS/EAACI (Fokkens et al, 2012) Position Paper on Rhinosinusitis and Nasal Polyps [Europe]
Phaeohyphomycosis (black moulds) ESCMID/ECMM (Chowdary et al, 2014) Diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi [Europe]
Pneumocystis pneumonia (PCP/PJP) RACP (Cooley et al, 2014) Diagnosis, prophylaxis and
management of Pneumocystis jirovecii pneumonia in patients
with haematological and solid malignancies
[Australasia]

 

ECIL (2016): preventiondiagnosistreatment [Europe]

ASTID (Fishman et al, 2019) PJP and solid organ transplants
PJP prophylaxis for children with tumours [USA]

Invasive candidiasis

Infection
GuidelinesCommentary/literature
Invasive Candida infectionsESCMID (2012) Europe:
–  Guideline development
– Diagnosis
–  Non-neutropenic adults
– Prevention and treatment in neonates and children
–  Adults with haematological malignancies, or after HSCT
– Haem-onc & ICU

RACP (Chen et al, 2014) Yeast infections in the haematology, oncology and intensive care setting [Australasia]

CDC (2020) C. auris prevention/control [USA]

ECIL-6 (Tissot et al, 2017) Invasive candidiasis, aspergillosis and mucormycosis in leukaemia/HSCT [Europe]

Expert panel (Alothman et al, 2014) Management of invasive Candida infections in adults [Middle East]

International Medicine Journal (Ong et al, 2019) Diagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases
Tagliaferri & Menichetti (2015) Treatment of invasive candidiasis: between guidelines and daily practice
 
Ahmed et al (2015) Invasive candidiasis in non-neutropenic critically ill – need for region-specific management guidelines
 
Tragiannidis et al (2014) Invasive candidiasis and candidaemia in neonates and children: update on current guidelines
Candidaemia
IDSA (Pappas et al, 2016) Management of candidiasis [USA]

EPICO 4.0 (Zaragoza et al, 2017) ‘Total quality’ in the management of invasive candidiasis in critically ill patients [Spain]

ESA (O’Leary et al, 2017) Management of Invasive Candidiasis and Candidemia in critically ill adults [Europe]

SBI/SPI/SBMT (Colombo et al, 2013) Management of candidiasis [Brazil]

LAIMN (Santolaya et al, 2013) Management of candidemia in children [Latin America]
Mellinghoff et al (2018) Equal Candida Score
 
Jack et al (2016) International guidelines: the need to standardize the management of candidaemia
Candida peritonitisISPD (Piraino et al, 2011) REDUCING THE RISKS OF PERITONEAL
DIALYSIS–RELATED INFECTIONS 
[International]

Jávea (Pemán et al, 2017) Candida peritonitis and other intra-abdominal fungal infections in non-neutropenic critically ill adult [Spain]
Montravers et al (2013) Intra-abdominal candidiasis: the guidelines-forgotten non-candidemic invasive candidiasis
Rare invasive yeastsESCMID/ECMM (Arendrup et al, 2014) iagnosis and management of rare invasive yeast infections [Europe]

Mucosal candidiasis

InfectionGuidelines
In patients with HIV/AIDSESCMID (Lortholary et al, 2012) Diagnosis and management of Candida diseases 2012: patients with HIV infection or AIDS [Europe]

Clinicalinfo.HIV.gov (2015) Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV [USA]
Oral IDSA (Pappas et al, 2016) Management of candidiasis [USA]

WHO (2014) Treatment of skin and
oral HIV-associated
conditions in children
and adults
 [International]
Oesophageal IDSA (Pappas et al, 2016) Management of candidiasis [USA]
Balanitis Int J STD & AIDS (Edwards et al, 2013) management of balanoposthitis [Europe]
VaginalInternational Journal of STD and AIDS. (Saxon et al, 2019) British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis [UK]

Mycoses (Farr et al, 2021) Guideline: vulvovaginal candidosis [Germany]

Center for Disease Control. Vulvovaginal Candidiasis (2020) [USA]

Allergic fungal conditions

ConditionGuidelines
ABPA ERS/ATS (Chung et al, 2014) Definition, evaluation and treatment of
severe asthma
[Europe]

IDSA (Patterson et al, 2016) Diagnosis and Management of Aspergillosis [USA]

Jat et al (2018) Childhood ABPA [India]
SAFSERS/ATS (Chung et al, 2014) Definition, evaluation and treatment of
severe asthma
[Europe]
Rhinosinusitis Singh et al (2017) Fungal Rhinosinusitis: Microbiological and Histopathological Perspective [India]
Thunderstorm asthma HPA (Dabrera et al, 2017) Overview of the evidence base
and implications for public health advice
[UK]

Alfred Health (2017) Prevention of thunderstorm asthma [Australia]

Chronic deep tissue & lung

InfectionGuidelines
Chronic pulmonary aspergillosis ESCMID-ECMM-ERS (Ullman et al, 2018) Diagnosis and management of Aspergillus diseases [Europe]

IDSA (Patterson et al, 2016) Diagnosis and Management of Aspergillosis [USA]

Salzer et al (2016) Characterization of CPA patients according to new ESCMID/ERS/ECMM and IDSA guidelines
COVID-19 associated pulmonary aspergillosis (CAPA)Hashim et al (2021) Practice Guidelines for the Diagnosis of COVID-19-Associated Pulmonary Aspergillosis in an Intensive Care Setting
Chronic cavitary pulmonary histoplasmosisIDSA (Wheat et al, 2007) Management of Patients with Histoplasmosis [USA]
Deep-seated mycosisDomestic guideline (Kohno et al, 2014) Management of Deep-seated Mycosis [Japan]
Coccidioidomycosis IDSA (Galgiani et al, 2016) Treatment of Coccidioidomycosis [USA]

Clinicalinfo.HIV.gov (2015) Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV [USA]
Paracoccidioidomycosis Universidade de São Paulo (Shikanai-Yasuda et al, 2017) Management of paracoccidioidomycosis [Brazil]
Fungal ball of the sinus IDSA (2008) [USA]

Yoon et al (2017) Retrospective of 538 cases, with recommendations [Korea]
Fungal keratitis International (2009) [International]

American Academy of Ophthalmology. Fungal Keratitis – Sub-Saharan Africa [Africa]

Skin, hair & nails

Infection Guidelines
Tinea capitisJournal of the German Society of Dermatology (Mayser et al, 2019) Guidelines: tinea capitis [German]
WHO (2014) international
Tinea crurisWHO (2014) international
AAD (1996)
Tinea manuumWHO (2014) international
AAD (1996)
Tinea corporis (ringworm)
Seborrhoeic dermatitis DSD (2015)
Pityriasis versicolor AAD (1996)
Hyalohyphomycosis (Fusarium, Scedosporium) ESCMID/ECMM (2014) diagnosis&management, Europe
Malassezia DSD (2015) treatment, Denmark
Onychomycosis BAD (2014)

Endemic mycoses

InfectionGuidelines
Sporotrichosis IDSA (2007) USA
Chromoblastomycosis ESCMID (2014) Europe
Blastomycosis IDSA (2008) USA

Other

OtherGuidelines
Diagnostics IDSA /ASM utilisation of microbiology laboratories (2018) USA
ID point-of-care testing (2016)
Genetic testing CPIC (2016) voriconazole and CYP2C19

Professional skills Writing SOPs in resource-poor settings (2016) in PLOS NTDs
Competency guidelines for PHL professionals (2015) CDC MMWR, USA
Implementing guidelines Birgand et al (2015) REVIEW
Overcoming the obstacles of implementing infection prevention and control guidelines
IRIS IRIS (2015) India
TDM
BSMM (Ashbee et al, 2013) TDM of antifungals [UK]

(Chau et al, 2014) Optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy [Australasia]
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