Rare and Emerging Fungal Pulmonary Infections

Abstract

The frequency and diversity of serious fungal infections are increasing. Persons who are severely immunocompromised are particularly vulnerable to infection from unusual molds and yeasts that are often found naturally in the environment. Clinical manifestations from these unusual fungal infections range from colonization of airways to chronic localized lesions to acute invasive or disseminated disease. When present, rare and emerging fungi are often isolated from the respiratory tract during a severely immunosuppressed state, and diagnosis requires isolation and identification of the infecting organism. Histopathology is often required to differentiate tissue invasion from airway colonization. There are no diagnostic serologies, and radiological exams are not specific. Furthermore, many emerging opportunistic molds demonstrate in vitro resistance to the older azoles and amphotericin B. As a result, successful treatment may require adjunct surgical debridement and, when possible, reconstitution of the host immune system. Also, the newer triazoles such as voriconazole and posaconazole may be useful to treat some of these infections caused by rare and emerging molds.

Fungal infections after lung transplantation

“…In addition to infrequent yeasts (Rhodotorula, Blastoschizomyces, Trichosporon and Geotrichum), rare moulds have emerged in the last two decades as pathogens in solid organ transplant (SOT) recipients, including zygomycetes, Scedosporium, Fusarium, Paecilomyces, Scopulariopsis, Acremonium, Tricoderma and others [22,23]. Many of these organisms mimic Aspergillus infection in tissue and must be distinguished in a culture.…”

Utility of PCR in Diagnosis of Invasive Fungal Infections: Real-Life Data from a Multicenter Study

“…Aspergillus spp. are generally susceptible to voriconazole, but mucormycetes are not (5,28,29). Such a diversity of fungal pathogens requires a broad-range PCR for fast and sensitive detection.…”

A Rare Case of Nasal Septal Perforation Due to Purpureocillium lilacinum: Case Report and Review

“…The genus Purpureocillium [5], earlier known as Paecilomyces, was first described by Bainer in 1907 [6]. They are saprophytic fungi found worldwide in soil and decomposing vegetation.…”

“…Purpureocillium lilacinum is an emerging, opportunistic fungal pathogen known to cause various infections in both immunocompromised and immunocompetent humans [1,6,9]. Rarely, it can cause infection of sino-nasal cavity.…”