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A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases

BACKGROUND: Phaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the...

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Autores principales: Revankar, Sanjay G, Baddley, John W, Chen, Sharon C -A, Kauffman, Carol A, Slavin, Monica, Vazquez, Jose A, Seas, Carlos, Morris, Michele I, Nguyen, M Hong, Shoham, Shmuel, Thompson, George R, Alexander, Barbara D, Simkins, Jacques, Ostrosky-Zeichner, Luis, Mullane, Kathleen, Alangaden, George, Andes, David R, Cornely, Oliver A, Wahlers, Kerstin, Lockhart, Shawn R, Pappas, Peter G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946886/
https://www.ncbi.nlm.nih.gov/pubmed/29766015
http://dx.doi.org/10.1093/ofid/ofx200
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author Revankar, Sanjay G
Baddley, John W
Chen, Sharon C -A
Kauffman, Carol A
Slavin, Monica
Vazquez, Jose A
Seas, Carlos
Morris, Michele I
Nguyen, M Hong
Shoham, Shmuel
Thompson, George R
Alexander, Barbara D
Simkins, Jacques
Ostrosky-Zeichner, Luis
Mullane, Kathleen
Alangaden, George
Andes, David R
Cornely, Oliver A
Wahlers, Kerstin
Lockhart, Shawn R
Pappas, Peter G
author_facet Revankar, Sanjay G
Baddley, John W
Chen, Sharon C -A
Kauffman, Carol A
Slavin, Monica
Vazquez, Jose A
Seas, Carlos
Morris, Michele I
Nguyen, M Hong
Shoham, Shmuel
Thompson, George R
Alexander, Barbara D
Simkins, Jacques
Ostrosky-Zeichner, Luis
Mullane, Kathleen
Alangaden, George
Andes, David R
Cornely, Oliver A
Wahlers, Kerstin
Lockhart, Shawn R
Pappas, Peter G
author_sort Revankar, Sanjay G
collection PubMed
description BACKGROUND: Phaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the goal of improving the recognition and management of these infections. METHODS: Patients from 18 sites in 3 countries were enrolled from 2009–2015. Cases were categorized as local superficial, local deep (pulmonary, sinus, osteoarticular infections), and disseminated infections. End points were clinical response (partial and complete) and all-cause mortality at 30 days and end of follow-up. RESULTS: Of 99 patients, 32 had local superficial infection, 41 had local deep infection, and 26 had disseminated infection. The most common risk factors were corticosteroids, solid organ transplantation, malignancy, and diabetes. Cultures were positive in 98% of cases. All-cause mortality was 16% at 30 days and 33% at end of follow-up, and 18 of 26 (69%) with dissemination died. Itraconazole was most commonly used for local infections, and voriconazole was used for more severe infections, often in combination with terbinafine or amphotericin B. CONCLUSIONS: Phaeohyphomycosis is an increasingly recognized infection. Culture remains the most frequently used diagnostic method. Triazoles are currently the drugs of choice, often combined with other agents. Further studies are needed to develop optimal therapies for disseminated infections.
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spelling pubmed-59468862018-05-15 A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases Revankar, Sanjay G Baddley, John W Chen, Sharon C -A Kauffman, Carol A Slavin, Monica Vazquez, Jose A Seas, Carlos Morris, Michele I Nguyen, M Hong Shoham, Shmuel Thompson, George R Alexander, Barbara D Simkins, Jacques Ostrosky-Zeichner, Luis Mullane, Kathleen Alangaden, George Andes, David R Cornely, Oliver A Wahlers, Kerstin Lockhart, Shawn R Pappas, Peter G Open Forum Infect Dis Major Article BACKGROUND: Phaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the goal of improving the recognition and management of these infections. METHODS: Patients from 18 sites in 3 countries were enrolled from 2009–2015. Cases were categorized as local superficial, local deep (pulmonary, sinus, osteoarticular infections), and disseminated infections. End points were clinical response (partial and complete) and all-cause mortality at 30 days and end of follow-up. RESULTS: Of 99 patients, 32 had local superficial infection, 41 had local deep infection, and 26 had disseminated infection. The most common risk factors were corticosteroids, solid organ transplantation, malignancy, and diabetes. Cultures were positive in 98% of cases. All-cause mortality was 16% at 30 days and 33% at end of follow-up, and 18 of 26 (69%) with dissemination died. Itraconazole was most commonly used for local infections, and voriconazole was used for more severe infections, often in combination with terbinafine or amphotericin B. CONCLUSIONS: Phaeohyphomycosis is an increasingly recognized infection. Culture remains the most frequently used diagnostic method. Triazoles are currently the drugs of choice, often combined with other agents. Further studies are needed to develop optimal therapies for disseminated infections. Oxford University Press 2017-09-26 /pmc/articles/PMC5946886/ /pubmed/29766015 http://dx.doi.org/10.1093/ofid/ofx200 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Major Article
Revankar, Sanjay G
Baddley, John W
Chen, Sharon C -A
Kauffman, Carol A
Slavin, Monica
Vazquez, Jose A
Seas, Carlos
Morris, Michele I
Nguyen, M Hong
Shoham, Shmuel
Thompson, George R
Alexander, Barbara D
Simkins, Jacques
Ostrosky-Zeichner, Luis
Mullane, Kathleen
Alangaden, George
Andes, David R
Cornely, Oliver A
Wahlers, Kerstin
Lockhart, Shawn R
Pappas, Peter G
A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
title A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
title_full A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
title_fullStr A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
title_full_unstemmed A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
title_short A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases
title_sort mycoses study group international prospective study of phaeohyphomycosis: an analysis of 99 proven/probable cases
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946886/
https://www.ncbi.nlm.nih.gov/pubmed/29766015
http://dx.doi.org/10.1093/ofid/ofx200
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