Diagnosis of Pneumonia Due to Invasive Molds
Pneumonia is the most common presentation of invasive mold infections (IMIs), and is pathogenetically characterized as angioinvasion by hyphae, resulting in tissue infarction and necrosis. <i>Aspergillus</i> species are the typical etiologic cause of mold pneumonia, with <i>A. fumi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/7/1226 |
| _version_ | 1797527335430258688 |
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| author | Carlo Foppiano Palacios Anne Spichler Moffarah |
| author_facet | Carlo Foppiano Palacios Anne Spichler Moffarah |
| author_sort | Carlo Foppiano Palacios |
| collection | DOAJ |
| description | Pneumonia is the most common presentation of invasive mold infections (IMIs), and is pathogenetically characterized as angioinvasion by hyphae, resulting in tissue infarction and necrosis. <i>Aspergillus</i> species are the typical etiologic cause of mold pneumonia, with <i>A. fumigatus</i> in most cases, followed by the <i>Mucorales</i> species. Typical populations at risk include hematologic cancer patients on chemotherapy, bone marrow and solid organ transplant patients, and patients on immunosuppressive medications. Invasive lung disease due to molds is challenging to definitively diagnose based on clinical features and imaging findings alone, as these methods are nonspecific. Etiologic laboratory testing is limited to insensitive culture techniques, non-specific and not readily available PCR, and tissue biopsies, which are often difficult to obtain and impact on the clinical fragility of patients. Microbiologic/mycologic analysis has limited sensitivity and may not be sufficiently timely to be actionable. Due to the inadequacy of current diagnostics, clinicians should consider a combination of diagnostic modalities to prevent morbidity in patients with mold pneumonia. Diagnosis of IMIs requires improvement, and the availability of noninvasive methods such as fungal biomarkers, microbial cell-free DNA sequencing, and metabolomics-breath testing could represent a new era of timely diagnosis and early treatment of mold pneumonia. |
| first_indexed | 2024-03-10T09:42:29Z |
| format | Article |
| id | doaj.art-d67afe6fcf4647378ee5aa48ddee45e5 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T09:42:29Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-d67afe6fcf4647378ee5aa48ddee45e52023-11-22T03:34:37ZengMDPI AGDiagnostics2075-44182021-07-01117122610.3390/diagnostics11071226Diagnosis of Pneumonia Due to Invasive MoldsCarlo Foppiano Palacios0Anne Spichler Moffarah1Department of Medicine, Division of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06519, USADepartment of Medicine, Division of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06519, USAPneumonia is the most common presentation of invasive mold infections (IMIs), and is pathogenetically characterized as angioinvasion by hyphae, resulting in tissue infarction and necrosis. <i>Aspergillus</i> species are the typical etiologic cause of mold pneumonia, with <i>A. fumigatus</i> in most cases, followed by the <i>Mucorales</i> species. Typical populations at risk include hematologic cancer patients on chemotherapy, bone marrow and solid organ transplant patients, and patients on immunosuppressive medications. Invasive lung disease due to molds is challenging to definitively diagnose based on clinical features and imaging findings alone, as these methods are nonspecific. Etiologic laboratory testing is limited to insensitive culture techniques, non-specific and not readily available PCR, and tissue biopsies, which are often difficult to obtain and impact on the clinical fragility of patients. Microbiologic/mycologic analysis has limited sensitivity and may not be sufficiently timely to be actionable. Due to the inadequacy of current diagnostics, clinicians should consider a combination of diagnostic modalities to prevent morbidity in patients with mold pneumonia. Diagnosis of IMIs requires improvement, and the availability of noninvasive methods such as fungal biomarkers, microbial cell-free DNA sequencing, and metabolomics-breath testing could represent a new era of timely diagnosis and early treatment of mold pneumonia.https://www.mdpi.com/2075-4418/11/7/1226invasive mold infectionspneumoniadiagnostics |
| spellingShingle | Carlo Foppiano Palacios Anne Spichler Moffarah Diagnosis of Pneumonia Due to Invasive Molds Diagnostics invasive mold infections pneumonia diagnostics |
| title | Diagnosis of Pneumonia Due to Invasive Molds |
| title_full | Diagnosis of Pneumonia Due to Invasive Molds |
| title_fullStr | Diagnosis of Pneumonia Due to Invasive Molds |
| title_full_unstemmed | Diagnosis of Pneumonia Due to Invasive Molds |
| title_short | Diagnosis of Pneumonia Due to Invasive Molds |
| title_sort | diagnosis of pneumonia due to invasive molds |
| topic | invasive mold infections pneumonia diagnostics |
| url | https://www.mdpi.com/2075-4418/11/7/1226 |
| work_keys_str_mv | AT carlofoppianopalacios diagnosisofpneumoniaduetoinvasivemolds AT annespichlermoffarah diagnosisofpneumoniaduetoinvasivemolds |