Abstract:Background: Invasive fungal diseases (IFD) are a serious threat, but physicians in Asia lack access to many advanced diagnostics in mycology. It is likely that they face other impediments in the management of IFD. A gap analysis was performed to understand the challenges Asian physicians faced in medical mycology. Methods: The Asia Fungal Working Group (AFWG) conducted a web-based survey on management practices for IFD among clinicians in China,
“… 70 Current challenges in diagnosis and management of COVID-19-associated mucormycosis are outlined in the panel . Current challenges in diagnosis and management of COVID-19-associated mucormycosis Little awareness of COVID-19-associated mucormycosis 71 The countries with a high incidence of diabetes and COVID-19 (eg, Bangladesh, India, Pakistan, Iran, Mexico, China, Russia, Indonesia, and the USA) should monitor patients closely for a month after recovery from COVID-19, as most cases of COVID-19-associated mucormycosis are detected within this time period. COVID-19-induced immune dysregulation is seen late in the COVID-19 clinical course.…”
Reportsof COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by the activation of antiviral immunity to SARS-CoV2, which might favour secondary infections. In this Review, we analysed 80 published and unpublished cases of COVID-19-associated mucormycosis. Uncontrolled diabetes, as well as systemic corticosteroid treatment, were present in most patients with COVID-19associated mucormycosis, and rhino-orbital cerebral mucormycosis was the most frequent disease. Mortality was high at 49%, which was particularly due to patients with pulmonary or disseminated mucormycosis or cerebral involvement. Furthermore, a substantial proportion of patients who survived had life-changing morbidities (eg, loss of vision in 46% of survivors). Our Review indicates that COVID-19-associated mucormycosis is associated with high morbidity and mortality. Diagnosis of pulmonary mucormycosis is particularly challenging, and might be frequently missed in India.
“… 70 Current challenges in diagnosis and management of COVID-19-associated mucormycosis are outlined in the panel . Current challenges in diagnosis and management of COVID-19-associated mucormycosis Little awareness of COVID-19-associated mucormycosis 71 The countries with a high incidence of diabetes and COVID-19 (eg, Bangladesh, India, Pakistan, Iran, Mexico, China, Russia, Indonesia, and the USA) should monitor patients closely for a month after recovery from COVID-19, as most cases of COVID-19-associated mucormycosis are detected within this time period. COVID-19-induced immune dysregulation is seen late in the COVID-19 clinical course.…”
Reportsof COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by the activation of antiviral immunity to SARS-CoV2, which might favour secondary infections. In this Review, we analysed 80 published and unpublished cases of COVID-19-associated mucormycosis. Uncontrolled diabetes, as well as systemic corticosteroid treatment, were present in most patients with COVID-19associated mucormycosis, and rhino-orbital cerebral mucormycosis was the most frequent disease. Mortality was high at 49%, which was particularly due to patients with pulmonary or disseminated mucormycosis or cerebral involvement. Furthermore, a substantial proportion of patients who survived had life-changing morbidities (eg, loss of vision in 46% of survivors). Our Review indicates that COVID-19-associated mucormycosis is associated with high morbidity and mortality. Diagnosis of pulmonary mucormycosis is particularly challenging, and might be frequently missed in India.
“…A recent survey in seven Asian countries reported a lack of formal training in medical mycology in 37% of clinicians; each clinician handles only 2–4 invasive fungal infections a month due to lack of suspicion and the absence of diagnostic mycology facilities; 80% of patients could not afford appropriate antifungal drugs. Clinicians fail to follow the standard guidelines of management; 34.3% of clinicians noted that they could not treat patients with appropriate antifungals due to the non-availability of the drug in their country [ 8 ]; It is estimated that two million serious fungal infections are present at any time in Latin American countries, 1.7 million serious fungal infections in 15 African countries and more than two million serious fungal infections in eight countries in Southeast Asia [ 9 ]; Certain game changers in fungal disease patterns have been noted over the years. Three important events over the last decade may explain the change in the paradigm of fungal infections.…”
Section: Present Statusmentioning
confidence: 99%
“…A recent survey in seven Asian countries reported a lack of formal training in medical mycology in 37% of clinicians; each clinician handles only 2–4 invasive fungal infections a month due to lack of suspicion and the absence of diagnostic mycology facilities; 80% of patients could not afford appropriate antifungal drugs. Clinicians fail to follow the standard guidelines of management; 34.3% of clinicians noted that they could not treat patients with appropriate antifungals due to the non-availability of the drug in their country [ 8 ];…”
Fungal infections have emerged as major threat to human beings. The world is not ready to face this formidable challenge due to limited awareness, insufficient laboratories, and difficulty in managing mycoses especially in developing countries. The International Society for Human and Animal Mycology (ISHAM) has undertaken several new initiatives to overcome these gaps, including a global outreach program with national affiliated mycology societies and other regional groups. ISHAM is working closely with the European Confederation of Medical Mycology (ECMM) and Global Action Fund for Fungal Infections (GAFFI) to enhance these efforts. The society has launched laboratory e-courses and is in the process of the development of clinical e-courses. ISHAM has partnered with regional conferences in South America and Asia by sponsoring international experts and young delegates. The society also supports young people from less developed countries to undergo training in laboratories of excellence. ISHAM facilitated the formation of the INFOCUS-Latin American Clinical Mycology Working Group (LATAM) and the Pan-African Mycology Working Group. The society appointed country ambassadors to facilitate coordination with national societies. Still, the task is enormous and ISHAM calls for strong advocacy and more coordinated activities to attract the attention of people from all disciplines to this neglected field.
“…Сложность представленного нами случая связана с отсутствием убедительных клинических проявлений кандидоза, отсутствием роста Candida при многократных бактериологических исследованиях крови и мочи, а также низкой настороженностью врачей в отношении генерализованного кандидоза у подростка без наличия факторов риска гематогенной диссеминации Candida. Необходимо отметить, что стерильная культура крови не исключает грибковой диссеминации [5].…”
Федеральное государственное бюджетное образовательное учреждение высшего образования «Московский государственный медикостоматологический университет имени А.И. Евдокимова» Министерства здравоохранения Российской Федерации, 127473, г. Москва, Российская Федерация 2 Государственное бюджетное учреждение здравоохранения «Инфекционная клиническая больница № 2» Департамента здравоохранения г. Москвы,
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
