Komkrit Ruangritchankul, Ariya Chindamporn, Navaporn Worasilchai, Ubon Poumsuk, Somboon Keelawat, Andrey Bychkov
Invasive fungal disease (IFD) has high mortality rate, especially in the growing population of immunocompromised patients. In spite of introduction of novel diagnostic approaches, the intravital recognition of IFD is challenging. Autopsy studies remain a key tool for assessment of epidemiology of visceral mycoses. We aimed to determine species distribution and trends of IFD over the last 10 years in unselected autopsy series from a large university hospital. Forty-five cases of visceral mycoses, confirmed by histopathology and panfungal PCR, were found in 587 consecutive autopsies. Major underlying diseases were diabetes mellitus (20%), hematologic malignancies (15.6%) and systemic lupus erythematosus (15.6%). There was a high risk for disseminated IFD in immunocompromised patients stayed in the hospital over 1 month with a fever longer than 3 weeks. The most common fungi were Aspergillus spp. (58%), Candida spp. (16%), Mucorales (14%) and Fusarium spp. (10%). We found significant increase in Aspergillus flavus (P = 0.04) and Mucorales (P < 0.01) infections over the last 5 years. Concordance rate between histopathology and panfungal PCR was 89.5% to the genus level. All 6 cases of fusariomycosis were misinterpreted as aspergillosis by histology alone. The precise species identification, necessary for targeted antifungal treatment, was rendered only by the molecular technique. Panfungal PCR showed high performance on formalin-fixed paraffin-embedded specimens, providing important epidemiological data in retrospective autopsy series. Rapid detection of fungi by panfungal PCR assay has high potential for intravital diagnostics of IFD in surgical and biopsy specimens.
Mycoses. 2001;44(7-8):253-60
[PMID:
11714058]
Am J Clin Pathol. 2003 Jun;119(6):854-8
[PMID:
12817433]
Crit Care. 2003 Dec;7(6):R129-32
[PMID:
14624686]
Mycoses. 2004 Feb;47(1-2):40-6
[PMID:
14998398]
Infect Immun. 2005 Jan;73(1):494-503
[PMID:
15618189]
Haematologica. 2006 Jul;91(7):986-9
[PMID:
16757415]
J Clin Microbiol. 2007 Feb;45(2):380-5
[PMID:
17122000]
Lancet. 2007 Apr 28;369(9571):1471-1480
[PMID:
17467518]
Transpl Infect Dis. 2008 Apr;10(2):106-9
[PMID:
17605727]
J Med Assoc Thai. 2007 Dec;90(12):2630-7
[PMID:
18386713]
Clin Infect Dis. 2008 Jun 15;46(12):1813-21
[PMID:
18462102]
Mycoses. 2008 Jul;51(4):291-300
[PMID:
18924260]
Lupus. 2009 Jun;18(7):661-6
[PMID:
19433470]
Am J Clin Pathol. 2009 Aug;132(2):221-7
[PMID:
19605816]
Dtsch Arztebl Int. 2008 Jul;105(28-29):501-6
[PMID:
19626203]
Am J Clin Pathol. 2009 Nov;132(5):746-55
[PMID:
19846817]
J Infect. 2010 Sep;61(3):259-65
[PMID:
20624423]
Clin Microbiol Rev. 2011 Apr;24(2):247-80
[PMID:
21482725]
J Clin Microbiol. 2011 Jun;49(6):2151-3
[PMID:
21508149]
Indian J Pathol Microbiol. 2011 Apr-Jun;54(2):344-9
[PMID:
21623087]
Med Mycol J. 2011;52(2):117-27
[PMID:
21788723]
Mycoses. 2012 Sep;55(5):435-43
[PMID:
22320199]
Pathol Res Pract. 2012 Sep 15;208(9):549-52
[PMID:
22840384]
Med Mycol. 2013 Jul;51(5):522-6
[PMID:
23327545]
Mycoses. 2013 Nov;56(6):638-45
[PMID:
23551865]
Diabetes. 1990 Mar;39(3):271-5
[PMID:
2407580]
Med Mycol. 2014 Nov;52(8):810-8
[PMID:
25231771]
F1000Prime Rep. 2014 Sep 04;6:81
[PMID:
25343038]
BMC Infect Dis. 2014 Dec 18;14:692
[PMID:
25518949]
Expert Opin Pharmacother. 2015 Feb;16(2):213-26
[PMID:
25579070]
Pathology. 2015 Apr;47(3):257-69
[PMID:
25719852]
Am J Clin Pathol. 2015 Jul;144(1):61-7
[PMID:
26071462]
Am J Clin Pathol. 2015 Aug;144(2):185-7
[PMID:
26185304]
Fungal Biol. 2016 Feb;120(2):279-87
[PMID:
26781382]
Infect Immun. 1982 Dec;38(3):1123-9
[PMID:
6818145]
Arch Pathol Lab Med. 1996 Aug;120(8):743-8
[PMID:
8718899]
Medicine (Baltimore). 1998 Jul;77(4):246-54
[PMID:
9715729]
