Non-Aspergillus Fungal Infections in Chronic Granulomatous Disease

Abstract

Purpose of Review

Management of Aspergillus infection in chronic granulomatous disease (CGD) patients remains a challenge even in new azoles era. However, epidemiology, diagnosis, and management of non-Aspergillus fungal infection (NAFI) in CGD setting are poorly described.

Recent Findings

NAFI appears to be rare in CGD patients and receiving antifungal prophylaxis. Clinical presentation is not specific of fungal species and patients often suffer from mild disease with prolonged course. While candidiasis and mucormycosis are also common in other immunocompromised population, infections caused by Phellinus tropicalis, Trichosporon inkin, and Rasamsonia argillacea have a unique predilection for CGD patients. Improved fungal identification with molecular methods allows description of new fungal species.

Summary

The available data for NAFI during CGD are limited and based on case reports and small series. Invasive tissue biopsies and advanced molecular methods are often required for diagnosis and guiding antifungal strategy in addition to a close collaboration between clinician, pathologist, and mycologist.

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Acknowledgments

We thank Marie Desnos-Ollivier for her helpful comments.

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Correspondence to Fanny Lanternier.

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Romain Guery reports participating in CME with support from Gilead outside the submitted work. Benoît Pilmis reports personal fees from MSD outside the submitted work. Fanny Lanternier reports personal fees from Gilead outside the submitted work. Bertrand Dunogue, Stéphane Blanche, and Olivier Lortholary declare no conflicts of interest relevant to this manuscript.

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Guery, R., Pilmis, B., Dunogue, B. et al. Non-Aspergillus Fungal Infections in Chronic Granulomatous Disease. Curr Fungal Infect Rep 13, 59–66 (2019). https://doi.org/10.1007/s12281-019-00339-5

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Keywords

  • Invasive fungal disease
  • Chronic granulomatous diseases
  • Trichosporon inkin
  • Phellinus tropicalis
  • Rasamsonia argillacea
  • Breakthrough infections
  • Pediatric patients