Division of Mycology, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Curr Opin Infect Dis. 2011 Dec;24(6):521-6. doi: 10.1097/QCO.0b013e32834ab21e.
The present review describes the emerging trends of mould infections in developing countries, and highlights the major epidemiological differences from the developed countries.
The limited data available from developing countries suggest an alarming increase in invasive mould infections, especially aspergillosis and mucormycosis, and also a difference in risk factors and causative agents between the developed and developing world. Sino-orbital, cerebral and ophthalmic infections due to Aspergillus flavus are the major clinical types in aspergillosis, after pulmonary aspergillosis. Aspergillus and Fusarium spp. are frequent causes of trauma-associated keratitis in agricultural workers. Rhino-orbito-cerebral presentation associated with uncontrolled diabetes is the predominant mucormycosis. Isolated renal mucormycosis has emerged as a new clinical entity. Apophysomyces elegans and Mucor irregularis are emerging species in these regions and uncommon agents such as Rhizopus homothallicus have also been reported. Many pathogens are geographically restricted, with Pythium insidionum, Rhinocladiella mackenziei and M. irregularis being described almost exclusively from Thailand, Middle East and China, respectively.
Despite limited studies, certain peculiarities have been observed in invasive mould infections in developing countries, including a high incidence of ophthalmic lesions, mucormycosis and aspergillosis; few different clinical presentations; and a varied spectrum of pathogens involved in such lesions.
本文描述了发展中国家新兴的霉菌感染趋势，并强调了与发达国家的主要流行病学差异。
发展中国家有限的数据表明侵袭性霉菌感染（尤其是曲霉病和毛霉病）呈惊人的上升趋势，而且在发达国家和发展中国家之间，危险因素和病原体也存在差异。黄曲霉引起的鼻窦-眶-脑感染是继肺曲霉病之后的主要临床类型。在农业工人中，曲霉属和镰刀菌属是创伤相关角膜炎的常见病原体。与未控制的糖尿病相关的鼻-眶-脑表现是主要的毛霉病。孤立性肾毛霉病已成为一种新的临床实体。弯颈霉和不规则毛霉在这些地区是新兴物种，而稀有的病原体如同源毛霉也有报道。许多病原体具有地理局限性，例如皮炎芽生菌、小克银汉霉和不规则毛霉几乎仅见于泰国、中东和中国。
尽管研究有限，但在发展中国家的侵袭性霉菌感染中观察到了某些特征，包括眼部病变、毛霉病和曲霉病的高发；较少的不同临床表现；以及涉及此类病变的病原体种类多样。
