Emerging fungal pathogens in pulmonary disease.
OBJECTIVE
Invasive fungal infections of the lung have been increasing due to the increase of the population most at risk. This review aims to describe some of the emerging fungal pathogens and their complex management.


RESULTS
With the increase in immunosuppressed populations, physicians are increasingly encountering uncommon fungal pathogens that historically have been difficult to identify and treat. Many of these fungal infections present with similar clinical features and often show similar histopathological changes. Treatment options are more complex because of an increasing number of antifungals that have become available for clinical use. The correct usage of these antifungals in addressing emerging fungal infections is unclear, however. Drawing from in-vitro and in-vivo susceptibility testing and case reports, some deductions may be made for the best empirical treatment of these deadly diseases. In general, the newer triazoles (voriconazole and posiconazole) and the use of combination therapy have shown promise.


CONCLUSIONS
Invasive fungal infections are on the increase and contribute significantly to overall mortality, particularly among transplant recipients. With the lack of well designed controlled clinical studies, physicians will need to draw from previously described cases and in-vitro susceptibility testing to optimize therapy.
Sanchez
Alejandro
A
University of Southern California, Division of Infectious Diseases, Los Angeles, California 90033, USA. asanchez@usc.edu
Larsen
Robert
R
D000935:Antifungal Agents / Q000627:therapeutic use*; D014943:Global Health; D006801:Humans; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
D000935:Antifungal Agents