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Journal of Antimicrobial Chemotherapy (2000) 45, 749-755
© 2000 The British Society for Antimicrobial Chemotherapy


Review

Invasive mycoses in organ transplant recipients: controversies in prophylaxis and management

Nina Singh*

VA Medical Center and University of Pittsburgh Thomas E. Starzl Transplantation Institute, Pittsburgh, Pennsylvania, USA


    Introduction
 
Organ transplant recipients are a growing and increasingly important group of immunocompromised hosts in whom invasive mycoses remain one of the most significant infectious complications.13 Although candida infections occur more frequently, the highest mortality rate associated with fungal infections in transplant recipients is for Aspergillus spp. infections.4 The last decade has witnessed the emergence of diverse mycelial fungi, including dematiaceous moulds, as significant pathogens in transplant patients.5 Trends in invasive fungal infections in the post-transplant setting have also been notable for a rise in non-albicans Candida spp.6

Given the high mortality associated with invasive mycoses in transplant recipients, effective prophylaxis for such infections is a worthy goal: an optimal approach has not, however, been devised. Uncertainty and controversy abound regarding the choice of antifungal agent, mode of drug delivery and types of patients who should receive antifungal prophylaxis. The lipid formulations of amphotericin B represent a significant advance in . . . [Full Text of this Article]


    Antifungal prophylaxis
 

    Antifungal therapy
 

    Adjunctive therapies
 
Role of surgery

Immunomodulatory therapies


    Notes
 

    References
 

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Clin. Microbiol. Rev.Home page
N. Singh and D. L. Paterson
Aspergillus Infections in Transplant Recipients
Clin. Microbiol. Rev., January 1, 2005; 18(1): 44 - 69.
[Abstract] [Full Text] [PDF]