Deep cutaneous fungal infections in solid-organ transplant recipients

Galezowski, A.; Delyon, Julie; Cléach, L. Le; Guégan, Sarah; Ducroux, Émilie; Alanio, Alexandre; Lastennet, Diane; Moguelet, Philippe; Dadban, A.; Leccia, Marie Thérèse; Pelletier, François; Françès, Camille; Lebbe, Célèste; Barète, Stéphane

doi:10.1016/j.jaad.2019.12.064

Cited by 14 publications

(16 citation statements)

References 17 publications

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“…An additional 246 cases were identified in 28 reports, but they did not meet our inclusion criteria (Table S5). 9,58,80,140,162,165,170–191 Characteristics of cases included in the present analysis are presented in Table 1. Proven fungal infections accounted for 96% (193/201) of cases, six cases were probable, and two cases were possible.…”

Section: Resultsmentioning

confidence: 99%

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis

Radcliffe

Azar

et al. 2022

Transplant Infectious Dis

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Background: Dematiaceous fungi cause a number of infectious syndromes referred to as phaeohyphomycosis among both immunocompetent and immunocompromised hosts. We performed a systematic review to characterize these infections in solid organ transplant recipients (SOTR). Methods:We searched PubMed database (last searched 1/6/2022) for Englishlanguage reports on dematiaceous fungal infections in SOTR. Included reports needed individualized demographic, treatment, and outcome data; pediatric reports were excluded. A universally applicable bias assessment was performed on reports. Models for infection type and outcome were created using the Bayesian paradigm. Results:We included 149 reports on 201 cases of dematiaceous fungal infections in SOTR. The mean age was 54 years, 72% were men, and kidney recipients accounted for 61% of cases. Skin and soft tissue infection (SSTI) was the most common infectious syndrome (73%). Death from infection occurred in 7% of cases (14/201), with disseminated (32%) cases having the highest mortality. Our model for infection type predicted the relative probability of central nervous system infection to be highest in liver recipients. Across all transplant types, higher relative probabilities of disseminated and pulmonary infections occur in the early post-transplant period, and the predicted probabilities for these infection types decreased after 100 months post-transplantation.Discussion: We identified SSTI as the most common dematiaceous fungal infections in SOTR. Disseminated infections carried the worst prognosis. The evidence in this review is limited by the heterogeneity of included cases. No funding source was used, and this review's protocol was not registered.

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Section: Resultsmentioning

confidence: 99%

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis

Radcliffe

Azar

et al. 2022

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…Phaeohyphomycoses are mostly reported in renal transplant recipients. 1 Phaeoacremonium species, darkly pigmented and environmental soil-related mold, are a heterogenous group of cutaneous, subcutaneous, and systemic infections. 2 Among them, P parasiticum is rarely reported.…”

Section: To the Editormentioning

confidence: 99%

“…A delay of several months between occurrence of cutaneous lesion and diagnosis is frequently observed. 1 Direct microscopy or histopathology showing dark hyphae leads to diagnosis. Molecular diagnostic allows faster identification and avoids the long delay of cultures.…”

Section: To the Editormentioning

confidence: 99%

“…2 Deep cutaneous fungal infections are more frequent in immunocompromised patients, particularly in adult solidorgan transplant recipients, and mostly occurs in the first 2 years after transplant. 1 Being a kidney transplant recipient and receiving a transplant after the age of 50 are identified risk factors. 3 Treatment aims to prevent a life-threatening fungal dissemination.…”

Section: To the Editormentioning

confidence: 99%

“…Data are scarce, and there is no available guideline to recommend systemic antifungal treatment alone or combined with surgery. 1 Among the broad-spectrum azoles, voriconazole offers preferable side effect profile and availability of an intravenous formulation. The optimal duration of therapy is unknown.…”

Section: To the Editormentioning

confidence: 99%

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