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Averting missed diagnosis of blastomycosis in an endemic region; understanding the rudiments

The average diagnostic delay of blastomycosis was 27 days, with 17% of patients experiencing delays of over a month. Most cases seen had ‘community-acquired pneumonia’. A retrospective analysis from a US study by Desmond Barber and colleagues reported pre-existing pulmonary conditions, diabetes mellitus and respiratory therapies as risk factors for delayed diagnosis of blastomycosis. 41% […]

Fatal outcomes in a yellow fever series linked with fungal pneumonia

A Brazilian autopsy-based case series (2017 to 2019) of yellow fever patients reported pneumonia or haemorrhage in the respiratory tract as the immediate cause of death in 31 (42.4%) cases. Microscopy detected yeasts and hyphae in 27 (37%) and 9 (12%) cases, respectively. The yeasts were morphologically similar to Candida species, while the hyphae had […]

Aspergillus IgG levels, a predictive tool for relapse in chronic pulmonary aspergillosis patients

A retrospective analysis of chronic pulmonary aspergillosis (CPA) patients has demonstrated the presence of Aspergillus sensitisation and a higher Aspergillus-specific IgG titre at completion of antifungal treatment as predictors of relapse. Contrastingly, no significant association was found between relapse and underlying lung conditions such as chronic obstructive pulmonary disease or prior TB.  This finding will […]

Isavuconazole, a suitable alternative for first-line treatment of invasive fungal disease in children

A Spanish paediatric case series, published in the Journal of Antimicrobial Chemotherapy, has demonstrated the safety and effectiveness of isavuconazole in treating invasive fungal disease (IFD) in children. Mendosa-Palomar et al. retrospectively analyzed 107 children (≤18 years) from nine public teaching hospitals in Spain, of whom isavuconazole was prescribed as treatment in 95 patients (89%) […]

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 […]

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