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

Invasive Fungal Disease in Patients with Newly Diagnosed Acute Myeloid Leukemia

“…These more difficult-to-treat mold infections, including fusariosis and mucormycosis, have been reported more often in patients who were receiving antifungal prophylaxis, as we observed in our cohort. However, we did not isolate unusual and rare molds, such as Scopulariopsis , Lomentospora , Lichtheimia , and Trichosporon , as has been noted in other recent reports [ 8 , 19 , 20 , 21 ]. It is likely that geographic and environmental factors are as important as the specific antifungal agent used for prophylaxis to explain differences in the molds that predominate in various different institutions.…”

“…Mold infections accounted for 71% of proven and probable IFD, with Aspergillus the predominant organism, similar to prior reports [ 1 , 10 ]. Increasingly, however, non- Aspergillus molds are responsible for infections in patients with acute leukemia [ 19 , 20 , 21 ]. These more difficult-to-treat mold infections, including fusariosis and mucormycosis, have been reported more often in patients who were receiving antifungal prophylaxis, as we observed in our cohort.…”

Fungal Infections Caused by Kazachstania spp., Strasbourg, France, 2007–2020

“…One case was a K. bovina bloodstream infection, and the other was mediastinis caused by K. slooffiae. An article about extremely rare invasive fungal infections collected in the FungiScope registry did not include any cases of Kazachstania infection ( 10 ).…”

All You Need to Know and More about the Diagnosis and Management of Rare Mold Infections

“…However, the selective pressure of antifungal prophylaxis may also 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). The intrinsic resistance of the fungal pathogens to many of the available antifungals limits successful therapeutic options (11,12). The reported prevalences of infection due to these rare fungal pathogens vary widely among geographic regions, driven by differences in climatic conditions, susceptible hosts, and diagnostic capabilities (10)(11)(12)(13)(14).…”

“…The intrinsic resistance of the fungal pathogens to many of the available antifungals limits successful therapeutic options (11,12). The reported prevalences of infection due to these rare fungal pathogens vary widely among geographic regions, driven by differences in climatic conditions, susceptible hosts, and diagnostic capabilities (10)(11)(12)(13)(14). The increasing availability of new nucleic acid amplification assays, blood culture detection systems, and lateral flow devices, as well as matrix-assisted laser desorption ionizationtime of flight (MALDI-TOF) mass spectrometry for the detection of medically important fungi and the laboratory diagnosis of invasive mycoses, warrants guidance in their use in clinical practice.…”