Abstract
ABSTRACTInvasive mold infections caused by molds other than Aspergillus spp. or Mucorales are emerging. The reported prevalences of infection due to these rare fungal pathogens vary among geographic regions, driven by differences in climatic conditions, susceptible hosts, and diagnostic capabilities. These rare molds—Fusarium, Lomentospora, and Scedosporium species and others—are difficult to detect and often show intrinsic antifungal resistance. Now, international societies of medical mycology and microbiology have joined forces and created the “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” (published in Lancet Infect Dis, https://doi.org/10.1016/S1473-3099(20)30784-2), with the goal of improving the diagnosis, treatment, prevention, and survival of persons with rare mold infections. The guideline provides cutting-edge guidance for the correct utilization and application of established and new diagnostic and therapeutic options.
Highlights
The fungal bloom at the end of the Cretaceous Period has favored the selection of endothermic mammals over ectothermic reptiles, because the warm body temperatures of mammals protected them from fungal diseases [1]
Commentary selective pressure of antifungal prophylaxis may contribute to the emergence of less common invasive mold infections, caused by molds that are often intrinsically resistant to some classes of antifungals, including Fusarium, Lomentospora, and Scedosporium species, as well as even less common emerging molds, such as Rasamsonia, Schizophyllum, Scopulariopsis, Purpureocillium, and Paecilomyces spp., which have been described as opportunistic pathogens in patients with a variety of underlying diseases [8,9,10]
For the in-press “Global Guideline for the Diagnosis and Management of Rare Mold Infections: an Initiative of the European Confederation of Medical Mycology (ECMM) in Cooperation with the International Society for Human and Animal Mycology (ISHAM) and the American Society for Microbiology (ASM)” [15], medical professionals from around the world, representing all United Nations regions and all medical disciplines involved in the management of invasive mold diseases, contributed their expertise and analyzed published evidence to develop global guidance for the diagnosis and management of rare mold infections
Summary
The fungal bloom at the end of the Cretaceous Period has favored the selection of endothermic mammals over ectothermic reptiles, because the warm body temperatures of mammals protected them from fungal diseases [1]. Commentary selective pressure of antifungal prophylaxis may contribute to the emergence of less common invasive mold infections, caused by molds that are often intrinsically resistant to some classes of antifungals, including Fusarium, Lomentospora, and Scedosporium species, as well as even less common emerging molds, such as Rasamsonia, Schizophyllum, Scopulariopsis, Purpureocillium, and Paecilomyces spp., which have been described as opportunistic pathogens in patients with a variety of underlying diseases [8,9,10].
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