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Treatment of Non-Aspergillus Mold Infections: a Focus on Mucormycosis and Fusariosis

  • Pakpoom Phoompoung
  • Me-Linh LuongEmail author
Fungal Infections (O De la Cruz and F Silveira, Section Editors)
  • 4 Downloads
Part of the following topical collections:
  1. Topical Collection on Fungal Infections

Abstract

Purpose of review

Mucormycosis and fusariosis are associated with severe morbidity and high fatality rate. This review will discuss the challenges associated with the treatment of mucormycosis and fusariosis with a focus on recent data on antifungal susceptibility, novel therapeutic modalities, and combination therapy. Overall, the review aims to provide guidance to optimize management of these difficult-to-treat infections.

Recent findings

Isavuconazole has comparable efficacy with liposomal amphotericin B for the treatment of mucormycosis. Treatment of fusariosis remains challenging, but voriconazole has been associated with improved outcome. Posaconazole has successfully been used as salvage therapy for both infections. Combination therapy is increasingly used although robust data supporting its efficacy is limited.

Summary

The first-line therapy for mucormycosis remains liposomal amphotericin B with posaconazole and isavuconazole being acceptable alternatives. Fusariosis should be treated with either voriconazole or liposomal amphotericin B. Combination therapy may have a role although its clinical benefit remains uncertain.

Keywords

Mucorales Fusarium Non-Aspergillus mold Mucormycosis Zygomycosis Fusariosis 

Notes

Compliance with ethical standards

Conflict of Interest

P.P. has no conflict of interest.

M.L. received research grant from Pfizer and consultation honoraria from Avir.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Infectious Disease, Multiorgan Transplant ProgramUniversity Health NetworkTorontoCanada
  2. 2.Division of Infectious Disease and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  3. 3.Department of Infectious Diseases and Medical MicrobiologyCentre Hospitalier de l’Université de Montréal (CHUM)MontrealCanada

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