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Invasive Fungal Disease in the Immunocompromised Host
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Invasive Fungal Disease in the Immunocompromised Host

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 4101

Special Issue Editor

Dr. Samir G. Agrawal

E-Mail Website
Guest Editor
Bart’s Health NHS Trust and Blizard Institute, Queen Mary University of London, London, UK
Interests: diagnosis of invasive fungal infections; clinical guidelines; audit tools; education; antimicrobial/antifungal stewardship

Special Issue Information

Dear Colleagues,

Invasive fungal infections continue to challenge healthcare professionals globally, and are particularly prevalent in the immunocompromised host.

This Special Issue will focus on the emerging data and trends regarding invasive fungal infections in the immunocompromised host, from diagnosis through to treatment, audit and guideline development.

The COVID-19 pandemic has also highlighted COVID-19-associated pulmonary aspergillosis (CAPA) and mucormycosis (CAM) as important developments, and these will be covered in this Special Issue.

This Special Issue, to be published in the Journal of Fungi, will also publish the accepted abstracts from the 17th Annual Fungal Update conference, which will be held in London on 10 and 11 June 2022. These abstracts will cover all aspects of invasive fungal disease, with topics from basic research through to patient treatment pathways.  

Dr. Samir G. Agrawal
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • invasive fungal infections
  • diagnostics in invasive fungal disease
  • antifungal stewardship
  • antifungal data, guidelines and audit
  • CAPA and CAM
  • host–pathogen interactions
  • evolving epidemiology of fungal infections

Published Papers (2 papers)

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Research

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11 pages, 1356 KiB  
Article
Invasive Fungal Disease in Patients with Myeloid Malignancies: A Retrospective Cohort Study of a Diagnostic-Driven Care Pathway Withholding Mould-Active Prophylaxis
by Elizabeth A. De Kort, Jochem B. Buil, Steven Schalekamp, Cornelia Schaefer-Prokop, Paul E. Verweij, Nicolaas P. M. Schaap, Nicole M. A. Blijlevens and Walter J. F. M. Van der Velden
J. Fungi 2022, 8(9), 925; https://doi.org/10.3390/jof8090925 - 31 Aug 2022
Cited by 2 | Viewed by 1936
Abstract
Objectives: Patients receiving remission induction therapy for acute myeloid leukaemia (AML) are at high risk of developing invasive fungal disease (IFD). Newer therapies with targeted antileukemic agents and the emergence of azole resistance pose a challenge to the strategy of primary antifungal prophylaxis. [...] Read more.
Objectives: Patients receiving remission induction therapy for acute myeloid leukaemia (AML) are at high risk of developing invasive fungal disease (IFD). Newer therapies with targeted antileukemic agents and the emergence of azole resistance pose a challenge to the strategy of primary antifungal prophylaxis. We report the experience of a diagnostic-driven care pathway (DCP) for the management of IFD in these patients, using only culture-directed mould inactive prophylaxis. Methods: Retrospectively, we used a single-centre study of consecutive patients receiving intensive chemotherapy for myeloid malignancies between 2014 and 2021. DCP consisted of serial cultures and serum galactomannan (sGM) screening, CT imaging, and bronchoscopy to direct targeted antifungal treatment. IFD was classified according to the 2020 EORTC/MSGERC criteria. Results: A total of 192 patients with myeloid malignancies received 300 courses of intensive chemotherapy. There were 14 cases of invasive yeast infections and 18 of probable/proven invasive mould disease (IMD). The incidence of probable/proven IMD during the first cycle of remission-induction chemotherapy was 4.6% (n = 9). sGM remained negative in all cases of invasive aspergillosis (IA), with positive mycology findings in bronchoalveolar lavage. All-cause mortality was 9.4% (n = 18) 100 days after starting chemotherapy and was comparable between patients with or without IFD. The fungal-related mortality was 1% (n = 2). Conclusion: Diagnostic-driven based management without universal mould active prophylaxis is a feasible strategy in the management of IFD and limits unnecessary antimould treatment during intensive chemotherapy. The poor performance of serial serum galactomannan screening in detecting IA warrants further investigation. Full article
(This article belongs to the Special Issue Invasive Fungal Disease in the Immunocompromised Host)
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14 pages, 1631 KiB  
Case Report
Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by Alternariaalternata in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review
by Giorgos Tyrellis, Maria Siopi, Danai Leventakou, Alexander Delides, Pavlos Maragkoudakis, George Korres, Christina Apostolopoulou, Alina-Roxani Gouloumi, Vasiliki Pappa, Spyros Pournaras, Ioannis Panayiotides and Joseph Meletiadis
J. Fungi 2022, 8(8), 879; https://doi.org/10.3390/jof8080879 - 20 Aug 2022
Cited by 1 | Viewed by 1747
Abstract
Alternaria spp. have emerged as opportunistic pathogens particularly in immunosuppressed patients. A case of a breakthrough acute invasive fungal rhinosinusitis (AIFRS), caused by Alternaria alternata, is reported in a patient with acute lymphoblastic leukemia (ALL) on anidulafungin therapy, who was successfully treated [...] Read more.
Alternaria spp. have emerged as opportunistic pathogens particularly in immunosuppressed patients. A case of a breakthrough acute invasive fungal rhinosinusitis (AIFRS), caused by Alternaria alternata, is reported in a patient with acute lymphoblastic leukemia (ALL) on anidulafungin therapy, who was successfully treated with liposomal amphotericin B and surgical intervention. To date, 20 cases of AIFRS due to Alternaria spp. have been described, 19 in the USA and 1 in Chile, making this case report the first case of AIFRS due to Alternaria in Europe. The patients had median (range) age 25 (2–56) years (65% female), almost all of them (19/20) with hematological diseases and severe neutropenia (8–41 days pre-infection). Amphotericin B was the most frequently used antifungal agent, either alone or in combination. In all of the cases, systemic antifungal therapy was combined with surgery. Despite stabilization or improvement of the AIFRS, mortality was 38% (5 days to 8 months post-surgical debridement) due to their underlying disease or other infections without sign of AIFRS at autopsy. Full article
(This article belongs to the Special Issue Invasive Fungal Disease in the Immunocompromised Host)
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