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Filamentous Fungi

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  • Authors: Margaret V. Powers-Fletcher1, Brian A. Kendall2, Allen T. Griffin4, Kimberly E. Hanson5
  • Editors: Randall T. Hayden7, Donna M. Wolk8, Karen C. Carroll9, Yi-Wei Tang10
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Department of Pathology; 2: Department of Pathology; 3: Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132; 4: Owensboro Health, Owensboro, KY 42303; 5: Department of Pathology; 6: Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132; 7: Clinical and Molecular Microbiology, Department of Pathology, St. Jude’s Children’s Research Hospital, Memphis, TN; 8: Geisinger Clinic, Department of Laboratory Medicine, Danville, PA; 9: Johns Hopkins University Hospital, Baltimore, MD; 10: Clinical Microbiology Service, Memorial Sloane-Kettering Institute, New York, NY
  • Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0002-2015
  • Received 02 March 2015 Accepted 08 June 2015 Published 03 June 2016
  • Kimberly E. Hanson, kim.hanson@hsc.utah.edu
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  • Abstract:

    Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnosis and aggressive treatment are essential for good clinical outcomes in immunocompromised patients. The host immune response plays an essential role in determining the course of exposure to potential fungal pathogens. Depending on the effectiveness of immune response and the burden of organism exposure, fungi can either be cleared or infection can occur and progress to a potentially fatal invasive disease. Nonspecific cellular immunity (i.e., neutrophils, natural killer [NK] cells, and macrophages) combined with T-cell responses are the main immunologic mechanisms of protection. The most common potential mold pathogens include certain hyaline hyphomycetes, endemic fungi, the , and some dematiaceous fungi. Laboratory diagnostics aimed at detecting and differentiating these organisms are crucial to helping clinicians make informed decisions about treatment. The purpose of this chapter is to provide an overview of the medically important fungal pathogens, as well as to discuss the patient characteristics, antifungal-therapy considerations, and laboratory tests used in current clinical practice for the immunocompromised host.

  • Citation: Powers-Fletcher M, Kendall B, Griffin A, Hanson K. 2016. Filamentous Fungi. Microbiol Spectrum 4(3):DMIH2-0002-2015. doi:10.1128/microbiolspec.DMIH2-0002-2015.

Key Concept Ranking

Fungal Infections
0.50070536
Antifungal Agents
0.4987392
0.50070536

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/content/journal/microbiolspec/10.1128/microbiolspec.DMIH2-0002-2015
2016-06-03
2017-09-19

Abstract:

Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnosis and aggressive treatment are essential for good clinical outcomes in immunocompromised patients. The host immune response plays an essential role in determining the course of exposure to potential fungal pathogens. Depending on the effectiveness of immune response and the burden of organism exposure, fungi can either be cleared or infection can occur and progress to a potentially fatal invasive disease. Nonspecific cellular immunity (i.e., neutrophils, natural killer [NK] cells, and macrophages) combined with T-cell responses are the main immunologic mechanisms of protection. The most common potential mold pathogens include certain hyaline hyphomycetes, endemic fungi, the , and some dematiaceous fungi. Laboratory diagnostics aimed at detecting and differentiating these organisms are crucial to helping clinicians make informed decisions about treatment. The purpose of this chapter is to provide an overview of the medically important fungal pathogens, as well as to discuss the patient characteristics, antifungal-therapy considerations, and laboratory tests used in current clinical practice for the immunocompromised host.

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Tables

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TABLE 1

Dual nomenclature of pathogenic pleomorphic fungi

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0002-2015
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TABLE 2

Common invasive mold infections stratified by risk group and predisposing factors

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0002-2015
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TABLE 3

Summary of possible antifungal susceptibility profiles for selected opportunistic filamentous fungi

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0002-2015
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TABLE 4

Epidemiologic cut-off values determined by the CLSI M38-A2 broth microdilution method for and species

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0002-2015

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