Exclusively Tracheobronchial Paracoccidioidomycosis

Corrêa, Liana Ferreira; Fritscher, Carlos Cézar; Fritscher, Renata Tramontin; Silva, Thiago Krieger Bento da; Fritscher, Leandro Genehr

doi:10.1016/j.chest.2021.06.077

Cited by 1 publication

(1 citation statement)

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“…Tracheobronchitis caused by invasive moulds, particularly Aspergillus spp., is well described, but tracheobronchial disease can also be caused by yeasts and dimorphic fungi [29,30]. Typically, ulceration, pseudomembranes, plaques, or eschars are seen on bronchoscopy but nodules mimicking tracheabronchial tumours also occur [14,29].…”

Section: Invasive Fungal Infections Of the Trachea And Bronchimentioning

confidence: 99%

Diagnosis of invasive respiratory mycoses in the immunocompromised host

Houston

Wilson

Stone

2023

Current Opinion in Pulmonary Medicine

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Purpose of reviewThe burden of invasive fungal infection is increasing worldwide, largely due to a growing population at-risk. Most serious human fungal pathogens enter the host via the respiratory tract. Early identification and treatment of invasive fungal respiratory infections (IFRIs) in the immunocompromised host saves lives. However, their accurate diagnosis is a difficult challenge for clinicians and mortality remains high.Recent findingsThis article reviews IFRIs, focussing on host susceptibility factors, clinical presentation, and mycological diagnosis. Several new diagnostic tools are coming of age including molecular diagnostics and point-of-care antigen tests. As diagnosis of IFRI relies heavily on invasive procedures like bronchoalveolar lavage and lung biopsy, several novel noninvasive diagnostic techniques are in development, such as metagenomics, ‘volatilomics’ and advanced imaging technologies.SummaryWhere IFRI cannot be proven, clinicians must employ a ‘weights-of-evidence’ approach to evaluate host factors, clinical and mycological data. Implementation studies are needed to understand how new diagnostic tools can be best applied within clinical pathways. Differentiating invasive infection from colonization and identifying antifungal resistance remain key challenges. As our diagnostic arsenal expands, centralized clinical mycology laboratories and efforts to ensure access to new diagnostics in low-resource settings will become increasingly important.

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