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Semin Respir Crit Care Med 2011; 32(6): 703-716
DOI: 10.1055/s-0031-1295718
© Thieme Medical Publishers

Pneumonia and Lung Infections due to Emerging and Unusual Fungal Pathogens

Sharon C.-A. Chen1 , 2 , Christopher C. Blyth3 , Tania C. Sorrell1 , 2 , Monica A. Slavin4
  • 1Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, Australia
  • 2Sydney Emerging Infectious Diseases Institute, University of Sydney, Sydney, Australia
  • 3Department of Paediatrics and Child Health, University of Western Australia, Perth, Australia
  • 4Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
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Publication History

Publication Date:
13 December 2011 (online)

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ABSTRACT

Invasive mold infections affecting the lungs are increasing in incidence and diversity. Severely immunocompromised patients are particularly vulnerable to infection from unusual, normally nonpathogenic fungi that are found naturally in the environment. Certain fungi such as Scedosporium and the dematiaceous fungi also cause lung disease in hosts without overt immune compromise. The impacts of these emerging pathogens range from airway colonization to locally invasive lung, and disseminated, disease. Diagnosis requires isolation and identification of the etiologic agent by either or both phenotypic and molecular biology methods. Evidence of tissue invasion on histopathology is often required to distinguish infection from colonization. Diagnostic imaging techniques are nonspecific, and there are no reliable serological biomarkers of infection. Many rare molds and yeasts demonstrate reduced in vitro susceptibility to antifungal agents. Although amphotericin B formulations remain clinically useful for many of these infections, voriconazole and posaconazole are more effective for some of these difficult-to-treat pathogens. Surgical resection of diseased tissue and support of the host immune system are often required to optimize outcomes.

KEYWORDS

Hyalohyphomycosis - phaeohyphomycosis - pneumonia

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Sharon C.-A. ChenPh.D. 

Centre for Infectious Diseases and Microbiology

Westmead Hospital, Darcy Road, Westmead NSW 2145, Australia

Email: sharon.chen@swahs.health.nsw.gov.au