Chowdhary, A., Meis, J. F., Guarro, J., de Hoog, G. S., Kathuria, S., Arendrup, M. C., Arikan-Akdagli, S., Akova, M., Boekhout, T., Caira, M., Guinea, J., Chakrabarti, A., Dannaoui, E., van Diepeningen, A., Freiberger, T., Groll, A. H., Hope, W. W., Johnson, E., Lackner, M., Lagrou, K., Lanternier, F., Lass-Floerl, C., Lortholary, O., Meletiadis, J., Munoz, P., Pagano, L., Petrikkos, G., Richardson, M. D., Roilides, E., Skiada, A., Tortorano, A. M., Ullmann, A. J., Verweij, P. E., Cornely, O. A. and Cuenca-Estrella, M. (2014). ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi. Clin. Microbiol. Infect., 20. S. 47 - 76. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

The aetiological agents of many invasive fungal infections are saprobes and opportunistic pathogens. Some of these fungi are darkly pigmented due to melanin production and traditionally have been named dematiaceous'. The melanized fungi cause a wide array of clinical syndromes ranging from superficial to deep-seated infections. Diagnosis relies on histopathological examination of clinical specimens and on examination of cultures. Sequencing is recommended for accurate species identification, especially for unusual or newly described pathogens. In cases of mycetoma and chromoblastomycosis, pathognomonic histological findings are useful and the Fontana-Masson stain, specific for melanin, usually confirms the diagnosis. There are no standardized therapies but voriconazole, posaconazole and itraconazole demonstrate the most consistent in vitro activity against this group of fungi. Oral itraconazole has been considered the drug of choice, given the extensive clinical experience with this drug. However, voriconazole may presumably be superior for central nervous system infections because of its ability to achieve good levels in the cerebrospinal fluid. Posaconazole is a well-tolerated alternative drug, backed by less clinical experience but with excellent salvage treatment results after failure of other antifungals. Amphotericin B has been useful as alternative therapy in some cases. Combination antifungal therapy is recommended for cerebral abscesses when surgery is not possible and for disseminated infections in immunocompromised patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Chowdhary, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meis, J. F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guarro, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Hoog, G. S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kathuria, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arendrup, M. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arikan-Akdagli, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Akova, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boekhout, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Caira, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guinea, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chakrabarti, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dannaoui, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Diepeningen, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Freiberger, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Groll, A. H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hope, W. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Johnson, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lackner, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lagrou, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lanternier, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lass-Floerl, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lortholary, O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meletiadis, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Munoz, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pagano, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petrikkos, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Richardson, M. D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roilides, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Skiada, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tortorano, A. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ullmann, A. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verweij, P. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, O. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cuenca-Estrella, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-442099
DOI: 10.1111/1469-0691.12515
Journal or Publication Title: Clin. Microbiol. Infect.
Volume: 20
Page Range: S. 47 - 76
Date: 2014
Publisher: ELSEVIER SCI LTD
Place of Publication: OXFORD
ISSN: 1469-0691
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CENTRAL-NERVOUS-SYSTEM; OCHROCONIS-GALLOPAVUM INFECTION; VITRO ANTIFUNGAL SUSCEPTIBILITY; ALTERNARIA-ALTERNATA INFECTION; RENAL-TRANSPLANT RECIPIENT; STEM-CELL TRANSPLANTATION; ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS; SCEDOSPORIUM-PROLIFICANS INFECTION; EXOPHIALA-DERMATITIDIS INFECTION; AMBULATORY PERITONEAL-DIALYSISMultiple languages
Infectious Diseases; MicrobiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44209

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