Invasive pulmonary aspergillosis (IPA) before liver transplantation increases mortality post-transplant by ~4x, according to Fang Chen and colleagues. Mortality with and without IPA was 38.1% vs 10.5% at 3 months (p= 0.049) and 42.9% vs 10.5% at 12 months (p = 0.026), respectively. These high mortality figures were despite antifungal therapy in 67% for a median […]
Albumin binding of fatty acids protects mammals from pulmonary mucormycosis
Mucormycosis especially affects those with poorly controlled diabetes, neutropenia and those with iron overload, as well as trauma victims. The immune defence against mucormycosis has long been assumed to be similar to that against other mould infections, but this is not the case. A remarkable and huge piece of translational pathogenesis work coordinated by Georgios […]
Is the prognosis of patients with fungal keratitis better with natamycin 5% plus voriconazole 1% combined compared with natamycin monotherapy?
A clinical trial conducted in India has reported that adjunctive topical voriconazole did not significantly improve clinical outcomes compared with natamycin 5% monotherapy. Di Zazzo and colleagues compared complete ulcer resolution with medical therapy and time to epithelial healing amongst 108 adults randomised 1:1 to receive either natamycin 5% plus voriconazole 1% (combination therapy) or natamycin 5% plus placebo […]
Fungal ball of the sinus – usually a benign long-term course without surgery
A remarkable paper from Itai Margulis and colleagues in Petah Tikva, Israel, identified an incidental fungus ball in the sinuses of 83 patients among 108,360 head CT scans (0.075%) over 12 years. The maxillary sinus was involved in 42 (50.6%), and the sphenoid in 36 (43.4%) patients and 81 (97.6%) were unilateral. Most of the patients were older people, with a […]
Is voriconazole superior to itraconazole in chronic pulmonary aspergillosis treatment?
A recent Indian study has shown that there is no difference in the proportion of patients with chronic pulmonary aspergillosis (CPA) who experience a favourable response following treatment with either itraconazole or voriconazole. The study also found similar rates of relapse in chronic pulmonary aspergillosis across the two groups. However, significantly more adverse events were associated […]
Isavuconazole therapy in critically ill adult patients with invasive aspergillosis showed a lower mortality compared with previous estimates
An Italian prospective, multicentre study by Giacobbe et al. showed a crude mortality rate of 44.0% at 30 days and 62.2% at 90 days in patients with proven or probable invasive aspergillosis receiving isavuconazole treatment while under intensive care. This was lower than rates reported in most of the current literature. A study conducted in […]
Assay of biochemical parameters may enhance the early detection of haemophagocytic lymphohistiocytosis in disseminated histoplasmosis.
Although reviews show disseminated histoplasmosis (DH) is commonly complicated with haemophagocytic lymphohistiocytosis (HLH), few studies haves described the clinical and laboratory features associated with HLH in patients with DH. Mandrell et al retrospectively analysed 110 participants with DH in the USA and reported an HLH prevalence of 20%. The HLH cohort had higher levels of […]
Invasive candidiasis and candidaemia among patients with acute pancreatitis
A new study by Liu et al has documented 114 cases of invasive candidiasis from a recent single-centre, retrospective analysis of patients with infected pancreatic necrosis. Of these, 60.5% had candidemia with or without pancreatic fungal infection, and 39.5% had isolated pancreatic fungal infection. Mixed fungal-bacterial co-infections were identified in 43.9 % of fungal-positive specimens. This […]
Antibody testing of the CSF is critical for the diagnosis of coccidioidal meningitis
A retrospective study conducted by Ravi et al in Arizona evidently showed that a combination of diagnostic tests provides the best diagnostic yield for coccidioidal meningitis. Fungal culture was positive in only 4.4% of cases. In this study, which recruited 110 participants, most cases were diagnosed via CSF antibody tests (93.7%). The positivity rate of […]
Is the NovaplexTM Dermatophyte qPCR assay preferred to conventional methods in the diagnosis of dermatomycoses?
The diagnosis of cutaneous fungal infections using direct microscopy and culture methods is quite challenging due to poor sensitivity and a long turnaround time, particularly associated with cultures. However, this may be the case only in settings lacking the capacity to utilise quantitative PCR for diagnosing dermatomycoses. Argente-Colàs and colleagues at the Navarra University Hospital […]