Department of Medicine, Division of Infectious Diseases and HIV Medicine, UH Cleveland Medical Center, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Infect Dis Clin North Am. 2018 Sep;32(3):687-701. doi: 10.1016/j.idc.2018.04.006.
Mold infections carry a substantial clinical and economic burden in solid organ transplant (SOT) recipients with a high overall mortality of near 30%. The most important pathogens include Aspergillus, the Zygomycetes, Fusarium, Scedosporium/Pseudallescheria, and the dematiaceous (dark) molds. Risk factors for the infections vary by transplant type but include degree of immune suppression and loss of skin or mucosal integrity. Correct diagnosis usually requires histopathology and/or culture. Management often requires a multidisciplinary team approach with combined antifungal and surgical therapies. This article reviews the epidemiology, risk factors, microbiology, diagnostic, and treatment approach to mold infections in SOT recipients.
霉菌感染给实体器官移植(SOT)受者带来了巨大的临床和经济负担,总死亡率接近 30%。最重要的病原体包括曲霉菌、接合菌、镰刀菌、帚霉/拟青霉属和暗色真菌。感染的危险因素因移植类型而异,但包括免疫抑制程度和皮肤或粘膜完整性的丧失。正确的诊断通常需要组织病理学和/或培养。治疗通常需要多学科团队的方法,结合抗真菌和手术治疗。本文综述了 SOT 受者霉菌感染的流行病学、危险因素、微生物学、诊断和治疗方法。