PURPOSETo review the characteristics and evolution of the fungal spectrum, and the risk factors causing fungal infection, and to make progress in diagnosing fungal infection after organ transplantation.

DATA SOURCESAn English-language literature search (MEDLINE 1990 - 2000) and bibliographic review of textbooks and review articles.

STUDY SELECTIONTwenty-three articles were selected from the literature that specifically addressed the stated purpose.

RESULTSFungal infections in organ transplant patients were generally divided into two types: (1) disseminated primary or reactivation infection with one of the geographically restricted systemic mycoses; (2) opportunistic infection by fungal species that rarely cause invasive infection in normal hosts. The risk factors of fungal infection after a transplant can be evaluated and predicted according to the organ recipient's conditions before, during and after the transplant. Progress in early diagnostic methods during the past 10 years has mainly revolved around two aspects, culture and non-culture.

CONCLUSIONSIt is important to undertake a systemic evaluation on the condition of the organ recipient before, during and after a transplant; should any risk factor for fungal infection be suspected, diagnosis should be made as early as possible by employing mycological techniques including culture and non-culture methods.

Humans ; Mycoses ; etiology ; Organ Transplantation ; Postoperative Complications

Child ; Child, Preschool ; Humans ; Male ; Mycoses ; etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; drug therapy ; Rhinitis ; etiology ; Sinusitis ; etiology

Trichosporonosis is a potentially life-threatening infection with Trichosporon beigelii, the causative agent of white piedra. The systemic infection by this fungus has been most frequently described in immunocompromised hosts with neutropenia. Here, we report the first patient with disseminated infection by T. beigelii in Korea, acquired during a period of severe neutropenia after chemo-therapy for myelodysplastic syndrome. The patient recovered from the infection after an early-intensified treatment with amphotericin B and a rapid neutrophil recovery. The disseminated infection by T. beigelii is still rare, however, is an emerging fatal mycosis in immunocompromised patients with severe neutropenia.
Adult ; Amphotericin B/therapeutic use ; Human ; Male ; Mycoses/drug therapy/*etiology ; Myelodysplastic Syndromes/*complications/drug therapy

OBJECTIVETo investigate the clinical features of invasive fungal infections (IFI) in the pediatric intensive care unit (PICU) and, to provide a basis for the effective prevention and treatment of IFI.

METHODSRetrospective analysis was performed on the clinical features and treatment outcomes of 38 children with IFI who were admitted to the PICU of Wuhan Children's Hospital between January 2009 and August 2012.

RESULTSPulmonary fungal infection (89%) was the most common among the 38 cases. Before diagnosis of IFI, all patients had severe underlying diseases and received several broad-spectrum antibiotics, including carbapenems, which were used in 95% of cases; 47% of all cases had been treated with corticosteroids systemically; all patients had received invasive operations, and 47% of them had undergone endotracheal intubation and mechanical ventilation. None of these cases had either typical clinical symptoms and signs or specific imaging findings. Fifty-six strains of fungi were isolated, with Candida albicans (41%), Aspergilli (25%), and Mucor (20%) being the most common ones. All patients received timely antifungal therapies, 15 cases were cured and 16 cases showed improvements, with a response rate of 82%, and the rate of adverse events was 16%.

CONCLUSIONSIn the PICU, the respiratory tract is the most common site of IFI infection, and Candida albicans is the leading pathogen. Severe underlying diseases, use of broad-spectrum antibiotics and corticosteroids, and invasive operations are the main risk factors for IFI in the PICU. Early diagnosis and timely treatment with high-performance antifungal drugs can improve the prognosis in children with IFI.

Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Mycoses ; diagnosis ; drug therapy ; etiology ; Retrospective Studies

Acupuncture Therapy ; Adult ; Female ; Foot Diseases ; complications ; microbiology ; Humans ; Lymphedema ; etiology ; therapy ; Mycoses ; complications ; microbiology

OBJECTIVE: Observing the anatomic variation and measuring the bone volume of meatus and nasal cavity by analyzing the expression of paranasal sinus CT. Searching whether these variation and volume data are related to maxillary fungal ball. METHOD: Measuring the double side bone volume of middle meatus,nasal cavity and the rate of middle meatus volume in the same side of nasal cavity respectively in the normal group, the maxillary fungal ball group. Observing the anatomic variation and statistically evaluating the anatomic variation and volume of nasal cavity and nasal meatus. RESULT: In the maxillary fungal ball group, the affected side and the contralateral side volume of middle meatus,nasal cavity and the rate of middle meatus volume in the nasal cavity had no statistical difference (P>0.05); Comparing the middle meatus volume and the rate of middle meatus of the maxillary fungus ball group affected side and normal group,there was statistical difference (P<0. 05). In the maxillary fungal ball group and the normal group, the morbidity of deviation septum were 24. 24% and 33. 33%, the morbidity of OMC variation were 30. 3% and 26. 67% (P<0.05), the morbidity of nasal anatomic variation were 54. 55% and 60.00%, there was no statistical difference (P>0.05). CONCLUSION Maybe there is a correlation between the enlarged bone middle meatus and the maxillary fungal ball. There is no relationship between the nasal anatomic variation and the maxillary fungal ball.
Humans ; Mycoses ; etiology ; Nasal Cavity ; anatomy & histology ; microbiology ; Nasal Septum ; Paranasal Sinuses

To increase the identification of pharyngeal bursa invasive fungal disease with lower cranial nerve involvement, reduce the misdiagnosis and improve the awareness of invasive fungal disease. We report the clinical data of a case with lower cranial nerve involvement as the first manifestation and reviewed the related literature.
Aged ; Cranial Nerves ; pathology ; Female ; Humans ; Mycoses ; complications ; pathology ; Pharyngeal Diseases ; etiology ; pathology

BACKGROUNDInvasive fungal infections are an important cause of posttransplant mortality in solid-organ recipients. The current trend is that the incidence of invasive candidiasis decreases significantly and invasive aspergillosis occurs later in the liver posttransplant recipients. The understanding of epidemiology and its evolving trends in the particular locality is beneficial to prophylactic and empiric treatment for transplant recipients.

METHODSA retrospective analysis was made of recorded data on the epidemiology, risk factors, and mortality of invasive fungal infections in 352 liver transplant recipients.

RESULTSForty-two (11.9%) patients suffered from invasive fungal infection. Candida species infections (53.3%) were the most common, followed by Aspergillus species (40.0%). There were 21 patients with a superficial fungal infection. The median time to onset of first invasive fungal infection was 13 days, first invasive Candida infection 9 days, and first invasive Aspergillus infection 21 days. Fifteen deaths were related to invasive fungal infection, 10 to Aspergillus infection, and 5 to Candida infection. Invasive Candida species infections were associated with encephalopathy (P = 0.009) and postoperative bacterial infection (P = 0.0003) as demonstrated by multivariate analysis. Three independent risk factors of invasive Aspergillus infection were posttransplant laparotomy (P = 0.004), renal dysfunction (P = 0.005) and hemodialysis (P = 0.001).

CONCLUSIONSThe leading etiologic species of invasive fungal infections are Candida and Aspergillus, which frequently occur in the first posttransplant month. Encephalopathy and postoperative bacterial infection predispose to invasive Candida infection. Posttransplant laparotomy and poor perioperative clinical status contribute to invasive Aspergillus infection. More studies are needed to determine the effect of prophylactic antifungal therapy in high risk patients.

Adult ; Aspergillosis ; etiology ; Candidiasis ; etiology ; Cryptococcosis ; etiology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Lung Diseases, Fungal ; etiology ; Male ; Middle Aged ; Mycoses ; etiology ; Retrospective Studies ; Risk Factors

The clinical manifestation of acute invasive fungal sinusitis was associated with facial pain,altered sense of smell, blindness and headache. Physical examinations show that dark brown nasal secretions with bone resorption in paranasal sinus. Radiographi parameters showed uneven density in paranasal sinus and intraorbital extension. Fungus smears and pathological examination can make a definitive diagnosis.
Acute Disease ; Facial Pain ; etiology ; Fungi ; isolation & purification ; Headache ; etiology ; Humans ; Mycoses ; complications ; pathology ; Paranasal Sinuses ; Sinusitis ; complications ; microbiology ; pathology

Acquired Immunodeficiency Syndrome ; complications ; Adult ; Diagnosis, Differential ; Humans ; Male ; Mycoses ; diagnosis ; etiology ; Penicillium ; isolation & purification ; Tomography, X-Ray Computed