Background: The incidence of invasive fungal infections increases worldwide, and rare fungi - neither belonging to the genera Aspergillus, Candida, Pneumocystis or Cryptococcus, nor being endemic, is increasingly identified as causative pathogens. Methods: We are coordinating a global registry for cases of rare invasive fungi. Our objective is to broaden the knowledge on epidemiology, to determine the clinical pattern of disease, to describe and improve diagnostic procedures and therapeutic regimens, as well as to facilitate exchange of clinical isolates among the contributors. Entry of retrospective data occurs via a web-based registration system (MACRO) that focuses on demographic information, underlying diseases, risk factors, details on the infection, therapy and outcome. Inclusion criteria include cultural, histopathological, antigen, or DNA evidence of invasive fungal infection. Infection due to Aspergillus spp., Candida spp., Cryptococcus neoformans, Pneumocystis jiroveci or any endemic fungal infection, as well as mere colonization or other non-invasive infections are exclusion criteria. For evaluable patient documentations, authorship positions in resulting publications will be available and a compensation of â‚¬100 each will be paid. If the documentation workload is too high, centers are encouraged to ask the study office for personnel to be sent to the site. For isolates made available to the central laboratory an additional â‚¬50 will be paid. Plasma levels of all common antifungals can be determined from serum, liquor, and other tissue samples. This service is provided for free to all participating investigators. Results: By now, 20 cases of rare invasive fungal infections have been identified, including Mucoclades corymbifera, Cunninghamella bertholletiae, Penicillium marneffei, Rhizomucor pusillus, as well as Acremonium spp., Fusarium spp., Coccidioides spp., and Trichoderma spp. Clinical results are partly pending. Most patients were in an immunocompromised state as a result of their underlying disease, chemotherapy or transplantation. Discussion: The clinical relevance of invasive fungal infections by rare fungi is increasing steadily. In a short period of time, actual cases from Germany, Austria, Italy and the United Kingdom could be documented, showing the broad spectrum of pathogens. Further investigators and coordinators are cordially invited to contribute to the success of Fungiscope.
Full conference title:
15th International Symposium on Infections in the Immunocompromised Host
- ISIIH 15th