Less than $1000 to save a life from cryptococcal meningitis with flucytosine
December 20, 2019
The extra cost to save 1 in 5 deaths from cryptococcal meningitis in AIDS is $973 according to Tinevimbo Shiri and colleagues. Using data from the ACTA trial, and assuming 14 days dual therapy with fluconazole and flucytosine, mortality falls from 53.8% to 35.1% over 10 weeks, and more over the following weeks. The additional…
Update of the EORTC consensus definitions of invasive fungal disease
December 9, 2019
The EORTC consensus definitions of invasive fungal infections have now been updated to include new patient groups (e.g. children and those taking ibrutinib) and diseases (e.g. Pneumocystis, endemic mycoses), and to reflect recent progress in diagnostics including Aspergillus/Candida PCR and galactomannan…
Diagnosis of tinea capitis in adults is challenging
December 9, 2019
Tinea capitis is uncommon in adults, and often initially misdiagnosed as bacterial folliculitis, allergic contact dermatitis, psoriasis or eczema…
NICU fluconazole prophylaxis may lead to malassezia colonisation and fungaemia
October 17, 2019
IDSA recommends fluconazole prophylaxis for the first six weeks in premature neonates weighing <1kg in units with high rates (>10%) of invasive candidiasis. Dr Chen and colleagues in Taiwan found that introducing fluconazole prophylaxis reduced cases of candidaemia from 1-2 cases per year (per ~780 patients) to zero. However, Malassezia colonisation and fungaemia rose during this time.
Medical experts stress the need for new ways of diagnosing neglected tropical fungal skin disease
October 1, 2019
An ad hoc panel of twenty three international medical experts from the fields of mycology, microbiology and dermatology, led by the International Foundation for Dermatology (IFD) and Global Action Fund for Fungal Infections (GAFFI), have put forward methods for developing essential diagnostic strategies for three major skin Fungal Neglected Tropical Diseases (NTDs). You can find…
Survey shows 27% of dermatologists use molecular methods in their daily practice
September 26, 2019
Superficial fungal infections have traditionally been diagnosed by direct microscopy, fungal culture and sometimes histopathology. Molecular methods have existed for many years, but improved uptake would be welcomed, particularly for detecting antifungal resistance…
Importance of GM-BAL screening for invasive pulmonary aspergillosis in liver disease patients
September 2, 2019
Invasive pulmonary aspergillosis (IPA) is a well-known risk for severely immunocompromised patients; in recent years, however, the infection has been increasingly recognised as an emerging disease in non-neutropenic, critically ill patients…
Candidaemia mortality is reduced by echinocandins only in the absence of septic shock
September 2, 2019
Mortality from candidaemia presenting with septic shock was similar in patients initially treated with either azoles or echinocandins (~50% in each case). However, mortality in those with candidaemia but without septic shock was approximately halved by initial treatment with an echinocandin (14.3%) rather than an azole (32.2%)…
Hyper-endemic areas for histoplasmosis revealed in new SE Asian maps
August 6, 2019
Researchers from Manchester (UK) and Jakarta (Indonesia) have published new prevalence data for histoplasmosis exposure for multiple countries in SE Asia. Sensitivity to the histoplasmin skin test was seen in a large proportion of the population (26-86%), so it is likely that rolling out the Histoplasma antigen test (now on the WHO Essential Diagnostics List) will help to diagnose cases and save lives…
Suspect histoplasmosis in returning travellers from an endemic area presenting with fever and cough
July 22, 2019
Histoplasmosis can present in a variety of ways, making it difficult to diagnose. Dr Staffolani and colleagues carried out a systematic review of 835 cases of histoplasmosis (including 45 clusters) from the literature, among immunocompetent patients who had recently returned from an endemic area. Manifestations included fever (91%), cough (55%), constitutional symptoms (58%), headache (52%) and chest pain (41%)…
Candida auris found among Russian ICU patients
July 16, 2019
Dr Barantsevich and colleagues describe a series of 49 trauma patients at an ICU in Moscow from whom Candida auris was isolated. Fluconazole resistance was widespread. However, no isolates were recovered by monthly swabbing of the hospital environment, healthcare workers’ hands and device…
Following GAFFI submission WHO endorses Histoplasma antigen as an Essential Diagnostic
July 11, 2019
The World Health Organisation has updated its Essential Medicines List to the Histoplasma antigen test, which can be used on urine to diagnose histoplasmosis in 48 hours. Rolling out this test worldwide could save up to 48,000 lives in 5 years…
LDBio rapid Aspergillus IgG test is sensitive and specific for chronic pulmonary aspergillosis
July 5, 2019
Lateral flow rapid diagnostics are sorely needed for many fungal infections. Scientists at the University of Manchester evaluated LDBio’s Aspergillus IgG test on patients at the National Aspergillosis Centre (UK). Compared to existing diagnostics, this test was more sensitive (91.6%) and more specific (98.0%) for chronic pulmonary aspergillosis…
Fungal asthma prevalence estimated for Sweden and Africa
June 19, 2019
Antifungal treatment can be useful for patients with severe asthma and fungal sensitisation, but this is limited by a lack of prevalence data. Two new papers aim to address this for Sweden (Backman et al) and 13 countries across Africa (Kwizera et al)…
Cluster of paracoccidioidomycosis cases in children in Argentina during the 1982-3 El Niño anomaly
June 12, 2019
Serious systemic paracoccidioidomycosis infections are often associated with men working in agriculture. Dr Guisano and colleagues describe a cluster of six cases in children in the NEA area of Argentina that occurred during the 1982-3 El Niño Southern Oscillation climatic anomaly, and suggest that climatic and anthropogenic changes may have played a role…
Side effects of long-term azole therapy
June 7, 2019
Azole antifungals are the first-line of treatment or prophylaxis for many fungal infections. They are often administered long-term (weeks to months), which can be associated with a number of adverse effects…
Paracoccidioidomycosis in South America should be a Neglected Fungal Tropical Disease
May 20, 2019
The Global Action Fund for Fungal Infections (GAFFI) has made the case for paracoccidioidomycosis (PCM) to be listed as a Neglected Tropical Disease (NTD) in a short paper published in Public Library of Science (PLoS) Neglected Tropical Diseases. PCM is endemic to the tropical regions of Latin America. PCM is an important cause of mortality…
Oropharyngeal histoplasmosis: a manifestation of disseminated disease
May 3, 2019
Histoplasmosis is a fungal infection endemic to areas of Central America and Midwest USA. Most people develop a mild form of infection and are asymptomatic; if symptoms do occur they are usually flu-like, but can vary greatly. In a few, usually immunosuppressed, patients the disease can progress to life-threatening, disseminated histoplasmosis. Dr Thais Pincelli and colleagues recently reviewed all 10 cases of oropharyngeal histoplasmosis identified over a 21 year period at the Mayo Clinic in Rochester, Minnesota…
1 in 15 TB sufferers go on to develop chronic pulmonary aspergillosis, treatment could save 1000s of lives
March 19, 2019
Around 1 in 15 people affected by tuberculosis are likely get the treatable fungal infection aspergillosis, according to research published today in the European Respiratory Journal by experts at the University of Manchester (UK) and Gulu Regional Referral Hospital (Uganda). The new knowledge could influence TB programs by helping doctors to identify – and treat…
New crop fungicides could increase antifungal resistance WHO requested to act
February 1, 2019
Antifungal triazole drugs are the mainstay of treatment for fungal diseases in humans and animals, yet their effectiveness is undermined by resistance. Very similar compounds are used on many crops to reduce plant fungal disease and increase yield. Today in Amsterdam, the Global Action Fund for Fungal infections published its letter to the World Health Organisation’s Director…