Opportunistic mycelial fungal infections in organ transplant recipients: Emerging importance of non-Aspergillus mycelial fungi

Shahid Husain, Barbara D. Alexander, Patricia Munoz, Robin K. Avery, Sally Houston, Timothy Pruett, Richard Jacobs, Edward A. Dominguez, Jan G. Tollemar, Katherine Baumgarten, Chen M. Yu, Marilyn M. Wagener, Peter Linden, Shimon Kusne, Nina Singh

Research output: Contribution to journalArticlepeer-review

280 Scopus citations

Abstract

To determine the spectrum and impact of mycelial fungal infections, particularly those due to non-Aspergillus molds, 53 liver and heart transplant recipients with invasive mycelial infections were prospectively identified in a multicenter study. Invasive mycelial infections were due to Aspergillus species in 69.8% of patients, to non-Aspergillus hyalohyphomycetes in 9.4%, to phaeohyphomycetes in 9.4%, to zygomycetes in 5.7%, and to other causes in 5.7%. Infections due to mycelial fungi other than Aspergillus species were significantly more likely to be associated with disseminated (P = .005) and central nervous system (P = .07) infection than were those due to Aspergillus species. Overall mortality at 90 days was 54.7%. The associated mortality rate was 100% for zygomycosis, 80% for non-Aspergillus hyalohyphomycosis, 54% for aspergillosis, and 20% for phaeohyphomycosis. Thus, non-Aspergillus molds have emerged as significant pathogens in organ transplant recipients. These molds are more likely to be associated with disseminated infections and to be associated with poorer outcomes than is aspergillosis.

Original languageEnglish (US)
Pages (from-to)221-229
Number of pages9
JournalClinical Infectious Diseases
Volume37
Issue number2
DOIs
StatePublished - Jul 15 2003

Bibliographical note

Funding Information:
Financial support: Educational grant from Enzon Pharmaceuticals, Pfizer, and a Medical School grant from Merck.

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