A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases.

dc.contributor.author

Revankar, Sanjay G

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Baddley, John W

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Chen, Sharon C-A

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Kauffman, Carol A

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Slavin, Monica

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Vazquez, Jose A

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Seas, Carlos

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Morris, Michele I

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Nguyen, M Hong

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Shoham, Shmuel

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Thompson, George R

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Alexander, Barbara D

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Simkins, Jacques

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Ostrosky-Zeichner, Luis

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Mullane, Kathleen

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Alangaden, George

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Andes, David R

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Cornely, Oliver A

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Wahlers, Kerstin

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Lockhart, Shawn R

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Pappas, Peter G

dc.date.accessioned

2022-10-03T11:08:47Z

dc.date.available

2022-10-03T11:08:47Z

dc.date.issued

2017-01

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2022-10-03T11:08:47Z

dc.description.abstract

Background

Phaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the goal of improving the recognition and management of these infections.

Methods

Patients from 18 sites in 3 countries were enrolled from 2009-2015. Cases were categorized as local superficial, local deep (pulmonary, sinus, osteoarticular infections), and disseminated infections. End points were clinical response (partial and complete) and all-cause mortality at 30 days and end of follow-up.

Results

Of 99 patients, 32 had local superficial infection, 41 had local deep infection, and 26 had disseminated infection. The most common risk factors were corticosteroids, solid organ transplantation, malignancy, and diabetes. Cultures were positive in 98% of cases. All-cause mortality was 16% at 30 days and 33% at end of follow-up, and 18 of 26 (69%) with dissemination died. Itraconazole was most commonly used for local infections, and voriconazole was used for more severe infections, often in combination with terbinafine or amphotericin B.

Conclusions

Phaeohyphomycosis is an increasingly recognized infection. Culture remains the most frequently used diagnostic method. Triazoles are currently the drugs of choice, often combined with other agents. Further studies are needed to develop optimal therapies for disseminated infections.
dc.identifier

ofx200

dc.identifier.issn

2328-8957

dc.identifier.issn

2328-8957

dc.identifier.uri

https://hdl.handle.net/10161/26030

dc.language

eng

dc.publisher

Oxford University Press (OUP)

dc.relation.ispartof

Open forum infectious diseases

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10.1093/ofid/ofx200

dc.subject

dematiaceous fungus

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itraconazole

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phaeohyphomycosis

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voriconazole

dc.title

A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases.

dc.type

Journal article

duke.contributor.orcid

Alexander, Barbara D|0000-0001-5868-0529

pubs.begin-page

ofx200

pubs.issue

4

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

pubs.organisational-group

Medicine

pubs.organisational-group

Pathology

pubs.organisational-group

Medicine, Infectious Diseases

pubs.publication-status

Published

pubs.volume

4

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