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2017 ; 4
(4
): ofx200
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A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An
Analysis of 99 Proven/Probable Cases
#MMPMID29766015
Revankar SG
; Baddley JW
; Chen SC
; Kauffman CA
; Slavin M
; Vazquez JA
; Seas C
; Morris MI
; Nguyen MH
; Shoham S
; Thompson GR 3rd
; Alexander BD
; Simkins J
; Ostrosky-Zeichner L
; Mullane K
; Alangaden G
; Andes DR
; Cornely OA
; Wahlers K
; Lockhart SR
; Pappas PG
Open Forum Infect Dis
2017[Fal]; 4
(4
): ofx200
PMID29766015
show ga
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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