Non-Aspergillus Fungal Infections in Transplant Patients

Fungal infections in recipients of solid organ and hematopoietic stem cell transplant recipients are significant causes of morbidity and mortality. Though relatively uncommon compared to other infectious complications, the difficulty in making a timely diagnosis and effectively treating patients presents a daunting challenge. Among the fungi responsible for these infections, there are many that are rarely encountered clinically yet are associated with high mortality in transplant patients. These include the darkly pigmented or dematiaceous fungi causing phaeohyphomycosis, Fusarium spp., Scedosporium spp., and Microsporidia. They have unique clinical presentations not typically seen with other fungal infections and often are not detected by standard diagnostic testing, with culture being the most reliable method to identify these pathogens. Due to the lack of randomized clinical trials, therapy is not standardized, and despite aggressive management strategies, mortality remains high for invasive disease. Further developments in specific diagnostic testing and antifungal drug therapy are needed to improve outcomes for these rare and often refractory infections.

DOI: 10.1007/978-3-030-01751-4_46-1