Abstract
Fungi such asFusarium spp.,Curvularia spp.,Alternaria spp. orTrichosporon beigelii, had been thought to represent contamination or harmless colonization when isolated from humans. More recently, the role of these and other newly recognized fungi as serious pathogens has been clearly established. Three diverse groups of fungi are responsible for these infections: the agents of phaeohyphomycosis and hyalohyphomycosis and certain yeasts. These infections, which have been encountered in both presumably healthy and immuno-compromised individuals, tend to be localized in the former, and disseminated and frequently fatal in the latter group of patients. A major concern is that these organisms are not uniformly susceptible to amphotericin B. Standardization of antifungal susceptibility testing may, therefore, be helpful in determining the antifungal drug of choice for each infection. It is also hoped that the advent of newer antifungals and biologic response modifiers will have a significant impact on the morbidity and mortality of these emerging infections.
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Bodey, G. P. The emergence of fungi as major hospital pathogens. Journal of Hospital Infection 1988, 11: 411–426.
Bodey, G. P. Topical and systemic antifungal agents. Medical Clinics of North America 1988, 72: 637–659.
Walsh, T. J., Pizzo, A.: Treatment of systemic fungal infections: recent progress and current problems. European Journal of Clinical Microbiology 1988, 460–475.
Horn, R., Wong, B., Kiehn, T. E., Armstrong, D. Fungemia in a cancer hospital: changing frequency, earlier onset, and results of therapy. Reviews of Infectious Diseases 1985, 7: 646–654.
Adam, R. D., Paquin, M. L., Petersen, E. A., Saubolle, M. A., Rinaldi, M. G., Corcoran, J. G., Galgiani, J. N., Sobonya, R. E. Phaeohyphomycosis caused by the fungal generaBipolaris andExserohilum: a report of 9 cases and review of the literature. Medicine 1986, 65: 203–217.
Anaissie, E., Kantarjian, H., Ro, J., Rolston, K., Fainstein, V., Bodey, G. P. The emerging role ofFusarium infections in patients with cancer. Medicine 1988, 67: 77–83.
June, C. H., Beatty, P. G., Shulman, H. M., Rinaldi, M. G. DisseminatedFusarium moniliforme infection after allogeneic marrow transplantation. Southern Medical Journal 1986, 79: 513–515.
Walling, D. M., McGraw, D. J., Merz, W. G., Karp, J. E., Hutchings, G. M. Disseminated infection withTrichosporon beigelii. Reviews of Infectious Diseases 1987, 9: 1013–1019.
Walsh, T. J., Newman, K. R., Moody, M., Wharton, R. C., Wade, J. C. Trichosporonosis in patients with neoplastic disease. Medicine 1986, 65: 268–279.
Hoy, J., Kuo-Ching, S., Rolston, K., Hopfer, R. L., Luna, M., Bodey, G. P. Trichosporon beigelii infection: A review. Reviews of Infectious Diseases 1986, 8: 959–967.
Ajello, L. Phaeohyphomycosis: definition and etiology. In: Mycoses. Scientific Publication No. 304. Pan American Health Organization, Washington, DC, 1975, p. 126–133.
Rippon, J. W. Phaeohyphomycosis. In: Rippon, J. W. (ed.): Medical mycology. Saunders, Philadelphia, 1988, p. 297–324.
Ajello, L. Hyalohyphomycosis and phaeohyphomycosis: two global disease entities of public health importance. European Journal of Epidemiology 1986, 2: 243–251.
Rinaldi, M. G., Phillips, P., Schwarts, J. G., Winn, R. E., Holt, G. R., Shagets, F. W., Elrold, J., Nishioka, E. G., Aufdemorte, T. B. HumanCurvularia infections: report of five cases and review of the literature. Diagnostic Microbiology and Infectious Disease 1987, 6: 27–39.
DeVault, G. A., Brown, S. T., King, J. W., Fowler, M., Oberle, A. Tenckhoff catheter obstruction resulting from invasion byCurvularia lunata in the absence of peritonitis. American Journal of Kidney Diseases 1985, 2: 124–126.
Kaufman, S. M. Curvularia endocarditis following cardiac surgery. Journal of Clinical Pathology 1971, 56: 466–470.
Loveless, M. O., Winn, R. E., Campbell, M., Jones, S. R. Mixed invasive infection withAlternaria spp. andCurvularia spp. American Journal of Clinical Pathology 1981, 76: 491–494.
McGinnis, M. R., Rinaldi, M. G., Winn, R. E. Emerging agents of phaeohyphomycosis: pathogenic species ofBipolaris andExserohilum. Journal of Clinical Microbiology 1986, 24: 250–259.
Rolston, K. V. I., Hopfer, R. L., Larson, D. L. Infections caused byDrechslera spp.: Case report and review of the literature. Reviews of Infectious Diseases 1985, 7: 525–529.
Sobol, S. M., Love, R. G., Stutman, H. R., Pysher, T. J. Phaeohyphomycosis of the maxilloethmoid sinus caused byDrechslera spicifera: a new fungal pathogen. Laryngoscope 1984, 94: 620–627.
Pedersen, N. B., Mardh, P. A., Hallberg, T., Jonsson, N. Cutaneous alternariosis. British Journal of Dermatology 1976, 94: 201–209.
Wyse, D. M., Malloch, D. Christmas tree allergy: mould and pollen studies. Canadian Medical Association Journal 1970, 103: 1272–1276.
Schlueter, D. P., Fink, J. N., Hensley, G. T. Wood-pulp workers' disease: a hypersensitivity pneumonitis caused byAlternaria. Annals of Internal Medicine 1972, 77: 907–714.
Wiest, P. M., Wiese, K., Jacobs, M. R., Morrissey, A. B., Abelson, T. I., Witt, W., Lederman, M. M. Alternaria infection in a patient with acquired immunodeficiency syndrome: case report and review of invasiveAlternaria infections. Reviews of Infectious Diseases 1987, 9: 799–803.
Young, N. A., Kwon-Chung, K. J., Kubota, T. T., Jennings, A. E., Fisher, R. I. Disseminated infection byFusarium moniliforme during treatment of malignant lymphoma. Journal of Clinical Microbiology 1978, 7: 589–594.
Mayer, C. F. Endemic panmyelotoxicosis in the Russian grain belt. Part I: The clinical aspects of alimentary toxic aleukia: a comprehensive review. Military Surgeon 1953, 113: 173–189.
Marshall, E. The soviet elephant grass theory. Science 1982, 217: 32.
Zaias, N. Superficial white onychomycosis. Sabouraudia 1966, 5: 99–103.
Zapater, R. C., Arrechea, A. Mycotic keratitits byFusarium. A review and report of two cases. Ophthalmologica 1975, 170: 1–12.
Forster, R. K., Zachary, I. G., Cottingham, A. J., Norton, E. W. D. Further observations on the diagnosis, cause, and treatment of endophthalmitis. American Journal of Ophthalmology 1976, 81: 52–56.
Guss, R. B., Koenig, S., De La Pena, W., Marx, M., Kaufman, H. E. Endophthalmitis after penetrating keratoplasty. American Journal of Ophthalmology 1983, 95: 651–658.
Young, C. N., Meyers, A. M. Opportunistic fungal infection byFusarium oxysporum in a renal transplant patient. Sabouradia 1979, 17: 219–223.
Benjamin, R. P., Callaway, J. L., Conant, N. F. Facial granuloma associated withFusarium infection. Archives of Dermatology 1970, 101: 598–600.
Chandrani, A. M., Anandakrishnam, C. Extensive subcutaneous hyphomycosis caused byFusarium oxysporum. Journal of Medical and Veterinary Mycology 1986, 24: 105–111.
Collins, M. S., Rinaldi, M. G. Cutaneous infection in man caused byFusarium monoliforme. Sabouraudi 1977, 15: 151–160.
Page, J. C., Friedlander, G., Dockery, G. L. PostoperativeFusarium osteomyelitis. Journal of Foot Surgery 1982, 21: 174–176.
Bourguignon, R. L., Wash, A. F., Flynn, J. C., Baro, C., Spinos, E. Fusarium species osteomyelitis. Case report. Journal of Bone and Joint Surgery 1976, 58: 722–723.
Nuovo, M. A., Simmonds, J. E., Chacho, M. S., McKitrick, J. C. Fusarium solani osteomyelitis with probable nosocomial spread. American Journal of Clinical Pathology 1988, 90: 738–741.
Jakle, C., Leek, J. C., Olson, D. A., Robbisn, D. L. Septic arthritis due toFusarium solani. Journal of Rheumatology 1983, 10: 151–153.
Young, J. B., Ahmed-Jushuf, I. H., Brownjohn, A. M., Parsons, F. M., Foulkes, S. J., Evans, E. G. Opportunistic peritonitis in continuous ambulatory peritoneal dialysis. Clinics of Nephrology 1984, 22: 268–269.
Steinberg, G. K., Britt, R. H., Enzmann, D. R., Finlay, J. L., Arvin, A. M. Fusarium brain abscess: case report. Journal of Neurosurgery 1983, 56: 598–601.
Valenstein, P., Schell, W. A. Primary intranasalFusarium infection: potential for confusion with rhinocerebral zygomycosis. Archives of Pathology and Laboratory Medicine 1986, 110: 751–754.
Merz, W. G., Karp, J. E., Hoagland, M., Jett-Goheen, M., Junkins, J. M., Hood, A. F. Diagnosis and successful treatment of fusariosis in the compromised host. Journal of Infectious Diseases 1988, 158: 1046–1055.
Richardson, S. E., Bannatyne, R. M., Summberbell, R. C., Milliken, J., Gold, R., Weitzman, S. S. Disseminated fusarial infection in the immunocompromised host. Reviews of Infectious Diseases 1988, 10: 1171–1181.
Venditi, M., Micozzi, A., Gentile, G., Polonelli, L., Morace, G., Bianco, P., Avvisati, G., Papa, G., Martino, P. InvasiveFusarium solani infections in patients with acute leukemia. Reviews of Infectious Disease 1988, 10: 653–659.
Ellis, J. J. Lesser known species in sectionLiseola ofFusarium and near relatives in theFusarium oxysporum group. Mycologia 1988, 80: 734–738.
Okuda, C., Sato, M. Y., Oka, K., Hotchi, M. Disseminated cutaneousFusarium infection with vascular invasion in a leukemic patient. Journal of Medical and Veterinary Mycology 1987, 25: 177–186.
Blazar, B. R., Hurd, D. D., Snover, D. C., Alexander, J. W., McGlane, P. B. InvasiveFusarium infections in bone marrow transplant recipients. American Journal of Medicine 1984, 77: 645–651.
Wheat, L. J., Bartlett, M., Cicarelli, M., Smith, J. W. OpportunisticScopulariopsis pneumonia in an immunocompromised host. Southern Medical Journal 1984, 77: 1608–1609.
Neglia, J. P., Hurd, D. D., Ferrieri, P., Snover, D. C. InvasiveScopulariopsis in the immunocompromised host. American Journal of Medicine 1987, 83: 1163–1166.
Rippon, J. W. Pseudallescheriasis. In: Rippon, J. W. (ed.): Medical mycology. Saunders, Philadelphia, 1988, 651–680.
Salkin, I. F., McGinnis, M. R., Dykstra, M. J., Rinaldi, M. G. Scedosporium inflatum, an emerging pathogen. Journal of Clinical Microbiology 1988, 26: 498–503.
Rippon, J. W. Hyalohyphomycosis, pythiosis, miscellaneous and rare mycoses, and algoses. In: Rippon, J. W. (ed.): Medical mycology. Saunders, Philadelphia, 1988, 714–745.
Rippon, J. W. Miscellaneous yeast infections. In: Rippon, J. W. (ed.): Medical Mycology. Saunders, Philadelphia, 1988, 610–617.
Dankner, W. M., Spector, S. A., Fierer, J., Davis, C. E. Malassezia fungemia in neonates and adults: complication of hyperalimentation. Reviews of Infectious Diseases 1987, 9: 743–753.
Aschner, J. L., Punsalang, A., Maniscalco, W. M., Menegus, M. A. Percutaneous central venous catheter colonization withMalassezia furfur: incidence and clinical significance. Pediatrics 1987, 80: 535–539.
Middleton, C., Lowenthal, R. M. Malassezia furfur fungemia as a treatable cause of obscure fever in a leukemia patient receiving parenteral nutrition. Australian and New Zealand Journal of Medicine 1987, 17: 603–604.
Redline, R. W., Dahmrs, B. B. Malassezia pulmonary vasculitis in an infant on long-term intralipid therapy. New England Journal of Medicine 1981, 305: 1395–1398.
Leeming, J. P., Notman, F. H. Improved methods for isolation and enumeration ofMalassezia furfur from human skin. Journal of Clinical Microbiology 1987, 25: 2017–2019.
Mickelsen, P. A., Viano-Paulson, M. C., Stevens, D. A., Diaz, P. S. Clinical and microbiological features of infection withMalassezia pachydermatis in high-risk infants. Journal of Infectious Diseases 1988, 157: 1163–1168.
Cimolai, N., Gill, M. J., Church, D. Saacharomyces cerevisiae fungemia: case report and review of the literature. Diagnostic Microbiology and Infectious Disease 1987, 8: 113–117.
Dougherty, S. H., Simmons, R. L. Postoperative peritonitis caused bySaccharomyces cerevisiae. Archives of Surgery 1982, 117: 248–249.
Eschete, L., West, B. C. Saccharomyces cerevisiae septicemia. Archives of Internal Medicine 1980, 140: 1539.
Krause, W., Matheis, H., Wulf, K.: Fungemia and funguria after oral administration ofCandida albicans. Lancet 1969, 598–599.
Klein, A. S., Tortora, G. T., Malowitz, R., Greene, W. H. Hansenula anomala: a new fungal pathogen. Two case reports and a review of the literature. Archives of Internal Medicine 1988, 148: 1210–1213.
Haron, E., Anaissie, E., Dumphy, F., McCredie, K., Fainstein, V. Hansenula anomala fungemia. Reviews of Infectious Diseases 1988 10: 1182–1186.
Ruane, P. J., Walker, L. J., George, W. L. Disseminated infection caused by urease-negativeCryptococcus neoformans. Journal of Clinical Microbiology 1988, 26: 2224–2225.
Powderly, W. G., Kobayashi, G. S., Herzig, G. P., Medoff, G. Amphotericin B-resistant yeast infection in severely immunocompromised patients. American Journal of Medicine 1988, 84: 826–832.
Drouhet, E., Dupont, B. Evolution of antifungal agents: past, present, and future. Reviews of Infectious Diseases 1987, 9, Supplement: 4–14.
Dismukes, W. E. Azole antifungal drugs: old and new. Annals of Internal Medicine 1988, 109: 177–179.
Clark, S. C. The human hematopoietic colony-stimulating factors. Science 1987, 236: 1229–1237.
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Anaissie, E.J., Bodey, G.P. & Rinaldi, M.G. Emerging fungal pathogens. Eur. J. Clin. Microbiol. Infect. Dis. 8, 323–330 (1989). https://doi.org/10.1007/BF01963467
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DOI: https://doi.org/10.1007/BF01963467