Invasive mold infections: recent advances in management approaches

Abstract

An increasing number of patients are undergoing transplantation procedures or receiving aggressive immunosuppression and chemotherapy. The growing population of immunocompromised hosts has led to a rise in the prevalence of invasive fungal infections (IFIs) due to yeasts and molds. Recent trends suggest that patients are acquiring infections with non-Candida albicans species, non-Aspergillus fumigatus species and non-Aspergillus molds such as Fusarium species, Scedosporium species and Zygomycetes. There are also a few reports of resistance to standard azole and echinocandin therapy, and some Aspergillus (A. ustus, A. terreus) and Scedosporium species are inherently resistant to polyenes. Early diagnosis and appropriate treatment of mold infections are important to improve outcomes. The use of high-resolution computed tomography scanning and new diagnostic tools such as the galactomannan and beta-glucan tests help early detection of IFIs. With the changing epidemiology of fungal infections and emergence of rare pathogens, and with the availability of a larger number of antifungal drugs, new management strategies are evolving to effectively treat invasive mold infections.