Practical issues related to non-Aspergillus invasive mold infections

• Published in: Molecular aspects of medicine 2023-12, Vol.94, p.101230-101230, Article 101230
• Main Authors: Nucci, Marcio, Nouér, Simone A.
• Format: Article
• Language: English
• Subjects: Antifungal Agents - therapeutic use; Filamentous fungi; Fungal infection; Fungi; Fusariosis; Fusariosis - drug therapy; Hematologic Neoplasms - drug therapy; Humans; Lomentospora; Mucormycosis; Mucormycosis - diagnosis; Mucormycosis - drug therapy; Mucormycosis - etiology; Scedosporium
• ISSN: 0098-2997; 1872-9452
• DOI: 10.1016/j.mam.2023.101230

Infection by non-Aspergillus molds has been increasingly reported. The management of such infections is challenging both for diagnosis and treatment, including the need of well-trained mycologists to properly identify rare fungi, difficulties in distinguishing between contamination, colonization and infection, the lack of randomized studies comparing different drugs or regimens, poor activity of available antifungal agents, lack of correlation between in vitro antifungal susceptibility tests and clinical outcome, and poor prognosis. Mucormycosis and fusariosis are the most frequent non-Aspergillus mold infections. Mucormycosis occurs more frequently in four major groups of patients: solid organ transplant recipients, patients with hematologic malignancies receiving chemotherapy or hematopoietic cell transplantation, diabetic patients, and immunocompetent individuals who suffer various types of skin and soft tissue trauma. Invasive fusariosis occurs almost exclusively in patients with hematologic malignancies. In this review we discuss practical issues related to the management of these and other non-Aspergillus mold infections. •Non-Aspergillus mold infections are relatively rare diseases, and the causative agents may differ according to the geographic region.•The most frequent non-Aspergillus mold infections are mucormycosis and fusariosis.•Mucormycosis affects four major groups of patients: solid organ transplant (SOT) recipients, patients with hematologic malignancies, diabetic patients, and immunocompetent individuals who suffer various types of skin and soft tissue trauma.•Invasive fusariosis usually occurs in two settings: acute leukemia and allogeneic hematopoietic cell transplantation.