Invasive fungal disease

Refractory fungal infection: Three case reports highlighting good practice

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This case series examines three patients with serious fungal infections that did not respond well to standard antifungal treatments. The cases demonstrate how fungi can develop resistance to common antifungal drugs like azoles, making infections harder to treat. The authors emphasize that accurate identification of the fungus, testing its sensitivity to drugs, monitoring drug levels in the blood, and careful use of antifungal medications are essential for successfully treating these difficult infections.

The Prognostic Value of (1→3)-β-D-Glucan in COVID-19 Patients with and Without Secondary Fungal Disease

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During COVID-19 infection, a fungal marker called beta-D-glucan (BDG) in the blood can predict patient survival even without a diagnosed fungal infection. Researchers found that COVID-19 patients with high BDG levels had a 91% death rate if not treated with antifungal drugs, but this dropped to 50% when antifungal therapy was given. The high BDG levels trigger a strong inflammatory response in the body that worsens disease severity, making BDG a valuable warning sign for doctors treating critically ill COVID-19 patients.

Antifungal persistence: Clinical relevance and mechanisms

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Some fungal infections don’t respond well to antifungal medications even though the fungi aren’t drug-resistant. This happens because a small percentage of fungal cells enter a dormant, low-energy state that protects them from being killed by the drugs. Understanding how these persistent cells survive and finding ways to target them could help prevent recurring fungal infections and improve treatment outcomes.

The diagnosis of mucormycosis by PCR in patients at risk: a systematic review and meta-analysis

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This study reviews how well a molecular test called PCR can diagnose mucormycosis, a dangerous fungal infection. Researchers analyzed 30 studies covering over 5,000 patient samples and found that PCR works very well for detecting this infection, especially when using samples from the lungs. Blood tests were also effective but slightly less sensitive. The study recommends using PCR as part of updated diagnostic guidelines to help doctors catch this serious infection earlier, potentially improving patient outcomes.

Clinical Significance and Therapeutic Challenges of Scedosporium spp. and Lomentospora prolificans Isolates in a Single-Center Cohort of Lung Transplant Recipients

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This study examined rare but serious fungal infections caused by Scedosporium and Lomentospora in lung transplant patients. Of 576 transplant recipients, 11 (2%) developed these infections, which are difficult to treat due to natural resistance to most antifungal medications. The infection type greatly influenced outcomes, with disseminated Lomentospora infections causing 100% mortality despite treatment. The research highlights the urgent need for new diagnostic methods and more effective antifungal drugs to combat these emerging pathogens.

Antifungal stewardship in the UK: where are we now?

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Fungal infections are becoming more common and dangerous because some fungi are developing resistance to antifungal medicines. UK hospitals struggle to manage these infections due to lack of funding, staffing, and limited access to fungal testing services. The paper recommends creating regional fungal expertise centers and setting national standards to improve how antifungal medications are used and monitored across the country.

Invasive Fungal Disease is Rare in Multiple Myeloma Patients Treated with BCMA CAR-T Therapy

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Researchers studied 234 multiple myeloma patients who received a cutting-edge cancer treatment called BCMA CAR-T therapy. While this therapy can cause serious side effects related to immune system activation, the study found that dangerous fungal infections were surprisingly rare, occurring in only 1.7% of patients. However, when fungal infections did occur in these patients, they tended to be severe and life-threatening, highlighting the need for careful monitoring of high-risk patients.

Shared Vision for Improving Outcomes for Serious Fungal Diseases: Report of a Patient, Caregiver, and Clinician Summit

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Patients with serious fungal infections face significant challenges including long delays before diagnosis, substantial emotional and financial burden, and lasting effects on quality of life. A summit brought together patients, their caregivers, and fungal disease experts to share experiences and identify priorities for improving care. The group identified needs for better diagnostic tools, new treatments, improved medical education about fungal diseases, and patient support programs to help future patients and their families navigate fungal infections more effectively.

Antifungal stewardship in the UK: where are we now?

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This paper examines how well the UK is currently managing antifungal stewardship—the appropriate use of antifungal medications to treat serious fungal infections while preventing resistance. Experts found that since 2017, progress has been limited due to lack of funding and staff expertise, difficulties accessing timely fungal diagnostic tests, and disruptions from the COVID-19 pandemic. The panel recommends creating regional mycology networks and diagnostic centres, establishing national standards for antifungal practices, and improving education about fungal infections to better prepare the UK for rising fungal disease threats.

The Prognostic Value of (1→3)-β-D-Glucan in COVID-19 Patients with and Without Secondary Fungal Disease

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During COVID-19, patients in intensive care sometimes develop dangerous fungal infections. Doctors use a blood test to measure a fungal marker called BDG to help diagnose these infections. This study found that even without confirmed fungal infection, high BDG levels predicted who would not survive, but giving antifungal medications improved survival even without proven infection.

Disease: Invasive fungal disease