Needles in a haystack: Extremely rare invasive fungal infections reported in FungiScope—Global Registry for Emerging Fungal Infections

Jon Salmanton-García, Philipp Koehler, Anupma Kindo, Iker Falces-Romero, Julio García-Rodríguez, Zdeněk Ráčil, Sharon C.A. Chen, Nikolai Klimko, Guillaume Desoubeaux, George R. Thompson, Miguel Ángel Benítez-Peñuela, José Yesid Rodríguez, Donald C. Sheppard, Martin Hoenigl, Yohann Le Govic, Hamid Badali, John W. Baddley, Jagdish Chander, Paul R. Ingram, Diana L. PakstisSibylle C. Mellinghoff, Serkan Atıcı, Simone Cesaro, Arunaloke Chakrabarti, Damien Dupont, Gloria M. González, Lóránt Hatvani, Raoul Herbrecht, Galina Klyasova, Cornelia Lass-Flörl, Mihai Mareș, Kathleen Mullane, Donald C. Vinh, Hilmar Wisplinghoff, Michaela Lackner, Oliver A. Cornely, Danila Seidel, Barbara D. Alexander, María Almagro-Molto, Eduardo Álvarez-Duarte, Martha Avilés-Robles, Aleksandra Barać, Vanda Chrenková, Patricia Cornejo-Juárez, Nicole Desbois-Nogard, Mario Fernández-Ruiz, Luis Figueira, Jesús García-Martínez, Sandra Gräber, Barbara Graf, Georg Haerter, Shariq Haider, Pamela Hartman, Melina Heinemann, Aamer Ikram, Frédéric Janvier, Jeffrey D. Jenks, Carol Kauffman, Robert Krause, Me Linh Luong, Shruti Malik, Vincent Marconi, Rodrigo Martino, Sanjay R. Mehta, Lisa Meintker, Andrea Mocná, Michele I. Morris, Alessandro C. Pasqualotto, Atul Patel, Olaf Penack, Nicolas Pichon, Mathias W. Pletz, Carlos Seas, Uluhan Sili, Monica Slavin, Kenji Uno, Jose A. Vazquez, Thomas Weber, Barbora Weinbergerova, Deniz Yilmaz-Karapinar, Seda Yilmaz-Semerci, Jin Yu

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Emerging invasive fungal infections (IFI) have become a notable challenge. Apart from the more frequently described fusariosis, lomentosporiosis, mucormycosis, scedosporiosis, and certain dematiaceae or yeasts, little is known about extremely rare IFI. Methods: Extremely rare IFI collected in the FungiScope registry were grouped as Dematiaceae, Hypocreales, Saccharomycetales, Eurotiales, Dermatomycetes, Agaricales, and Mucorales. Results: Between 2003 and June 2019, 186 extremely rare IFI were documented in FungiScope. Dematiaceae (35.5%), Hypocreales (23.1%), Mucorales (11.8%), and Saccharomycetales (11.3%) caused most IFI. Most patients had an underlying malignancy (38.7%) with acute leukemia accounting for 50% of cancers. Dissemination was observed in 26.9% of the patients. Complete or partial clinical response rate was 68.3%, being highest in Eurotiales (82.4%) and in Agaricales (80.0%). Overall mortality rate was 29.3%, ranging from 11.8% in Eurotiales to 50.0% in Mucorales. Conclusions: Physicians are confronted with a complex variety of fungal pathogens, for which treatment recommendations are lacking and successful outcome might be incidental. Through an international consortium of physicians and scientists, these cases of extremely rare IFI can be collected to further investigate their epidemiology and eventually identify effective treatment regimens.

Original languageEnglish (US)
Pages (from-to)802-815
Number of pages14
JournalJournal of Infection
Volume81
Issue number5
DOIs
StatePublished - Nov 2020

Keywords

  • Invasive fungal infections
  • Mold
  • Rare
  • Registry
  • Yeast

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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