Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Apr;24(2):e13819.
doi: 10.1111/tid.13819. Epub 2022 Mar 14.

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta-analysis

Christopher Radcliffe  1 , Andrew J Radcliffe  2 , Marwan M Azar  1   3 , Matthew Grant  1   3
Affiliations
Meta-Analysis

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta-analysis

Christopher Radcliffe et al. Transpl Infect Dis. 2022 Apr.

Abstract

Background: Dematiaceous fungi cause a number of infectious syndromes referred to as phaeohyphomycosis among both immunocompetent and immunocompromised hosts. We performed a systematic review to characterize these infections in solid organ transplant recipients (SOTR).

Methods: We searched PubMed database (last searched 1/6/2022) for English-language reports on dematiaceous fungal infections in SOTR. Included reports needed individualized demographic, treatment, and outcome data; pediatric reports were excluded. A universally applicable bias assessment was performed on reports. Models for infection type and outcome were created using the Bayesian paradigm.

Results: We included 149 reports on 201 cases of dematiaceous fungal infections in SOTR. The mean age was 54 years, 72% were men, and kidney recipients accounted for 61% of cases. Skin and soft tissue infection (SSTI) was the most common infectious syndrome (73%). Death from infection occurred in 7% of cases (14/201), with disseminated (32%) cases having the highest mortality. Our model for infection type predicted the relative probability of central nervous system infection to be highest in liver recipients. Across all transplant types, higher relative probabilities of disseminated and pulmonary infections occur in the early post-transplant period, and the predicted probabilities for these infection types decreased after 100 months post-transplantation.

Discussion: We identified SSTI as the most common dematiaceous fungal infections in SOTR. Disseminated infections carried the worst prognosis. The evidence in this review is limited by the heterogeneity of included cases. No funding source was used, and this review's protocol was not registered.

Keywords: Alternaria; Exophiala; dematiaceous fungi; phaeohyphomycosis; solid organ transplant.

PubMed Disclaimer

References

REFERENCES

    1. Revankar SG, Sutton DA. Melanized fungi in human disease. Clin Microbiol Rev. 2010;23(4):884-928. https://doi.org/10.1128/CMR.00019-10.
    1. Wong EH, Revankar SG. Dematiaceous molds. Infect Dis Clin North Am. 2016;30(1):165-178. https://doi.org/10.1016/j.idc.2015.10.007.
    1. Smith DFQ, Casadevall A. The role of melanin in fungal pathogenesis for animal hosts. Curr Top Microbiol Immunol. 2019;422:1-30. https://doi.org/10.1007/82_2019_173.
    1. Jacobson ES. Pathogenic roles for fungal melanins. Clin Microbiol Rev. 2000;13(4):708-717. https://doi.org/10.1128/cmr.13.4.708-717.2000.
    1. Revankar SG, Patterson JE, Sutton DA, Pullen R, Rinaldi MG. Disseminated phaeohyphomycosis: review of an emerging mycosis. Clin Infect Dis. 2002;34(4):467-476. https://doi.org/10.1086/338636.

Substances

LinkOut - more resources