Emerging moulds: Fusarium, Scedosporium and Zygomycetes in transplant recipients

Abstract

Purpose of review: The incidence of non-Aspergillus mould infections in transplant recipients has increased over the past decade. This paper will review recent data regarding the epidemiology, clinical manifestations, treatment and the outcome of infections caused by Fusarium spp., Scedosporium spp. and the Zygomycetes in transplant recipients.

Recent findings: Although the reasons for the increased incidence of non-Aspergillus mould infections in transplant recipients are not very clear, changes in transplant procedures, resulting in more severe immunosuppression, seem to play a major role, as suggested by recent epidemiologic data. Infections caused by these fungi have a tendency to be disseminated, and the prognosis is usually poor because the fungi are resistant to most of the available antifungal agents. New drugs, particularly the new azoles, may have a role in the treatment and prophylaxis of these infections, but the available data are still scant.

Summary: The understanding of the changing epidemiology of fungal infections and their implications for the prognosis of transplant recipients are important to better evaluate the impact of new transplant procedures.