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Emerging Fungal Infections in Solid Organ Transplantation

S. Huprikar,S. Shoham

Published 2013 in American Journal of Transplantation

ABSTRACT

Infections due to a variety of generally innocuous fungi are increasingly recognized as a problem in solid organ transplant (SOT) recipients (1–5). These organisms include filamentous fungi such as members of the Zygomycetes class (order Mucorales), Fusarium, Scedosporium, yeastlike organisms such as Trichosporon, Malessezia and Rhodotorula and the dematiaceous fungi (a collective term referring to a variety of darkly pigmented fungi) (6–13). Diseases caused by these diverse fungi are collectively known as “emerging” or “rare” fungal infections. The clinical manifestations and diagnosis of emerging and rare fungal infections are summarized in Table 1. Since these fungi cause a minority of infections in SOT, data regarding treatment options are limited. All of the treatment recommendations in these guidelines are derived from small case series, anecdotal experiences, and joint center reviews and are summarized in Table 2 (evidence grade III). Data gleaned from non-SOT populations, such as patients with hematological malignancies and/or HSCT, further inform decisions regarding these infections (6,14–18). Since data are quite limited, distinctions between adult and pediatric patients are not addressed in these guidelines.

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