LIVING WITH IT WORKING WITH IT TREATING IT
Anyone can get a fungal infection, even people who are otherwise healthy. Fungi are common in the environment, and people breathe in or come in contact with fungal spores every day without getting sick. However, in people with weak immune systems, these fungi are more likely to cause an infection.
Infections that happen because a person’s immune system is weak are called opportunistic infections. These illnesses can be caused by bacteria, viruses, or fungi. Many fungal infections are opportunistic infections.
Some people are born with a weak immune system. Others may have an illness that attacks the immune system such as HIV/AIDS. Some medications, like corticosteroids or cancer chemotherapy, can also lower the body’s ability to fight infections.
If you have a weakened immune system, you should be aware that fungal infections can happen. Learning about fungal infections can help you and your doctor recognize them early. This may help prevent serious complications.
As a stem cell transplant patient, you have new opportunities for a healthy and full life. Stem cell transplants have many benefits, but they also have risks. Because stem cell transplants destroy and rebuild your immune system, they increase your risk for fungal infections.
There are two main types of stem cell transplants:
There are different reasons for receiving either type of transplant. You and your healthcare provider will discuss your options and choose the treatment that’s best for you.
A transplant using stem cells from a donor increases your risk for fungal infection more than a transplant that uses stem cells from your own body. If your stem cells come from another person, you will need to take anti-rejection medication. This medication weakens your immune system.1
Chemotherapy and radiation lower your white blood cell count. As you recover from your transplant, your white blood cell count can become very low, also known as neutropenia[PDF - 4 pages]. During this time, your body will have trouble fighting infections, including fungal infections.2
Graft-versus-host disease (GVHD). If you receive stem cells from a donor, the transplanted stem cells may attack your body. This is known as graft-versus-host disease, which can increase your risk for fungal infection.3 The steroid medications given to treat graft-versus-host disease can also increase the chance of getting a fungal infection. 4
Fungal infections can range from mild to life-threatening. Some fungal infections are mild skin rashes, but others can be deadly, like fungal pneumonia. Because of this, it’s important to seek treatment as soon as possible to try to avoid serious infection.
Fungal infections can look like bacterial or viral infections. If you’re taking medicine to fight an infection and you aren’t getting better, ask your doctor about testing you for a fungal infection.
Fungal infections can happen any time after your transplant. Fungal infections can happen days, weeks, or months after the stem cell transplant. If you develop GVHD, you’re at risk for a longer period of time.5
Some types of fungal infections are more common than others in stem cell transplant patients. Aspergillosis is the most common type of fungal infection in stem cell transplant patients, followed by Candida infection and mucormycosis, but other types of fungal infections are also possible.1
Your hospital stay matters. After your transplant, you may need to stay in the hospital for a long time. While there, you may need to have procedures that can increase your chance of getting a fungal infection. Please see the following sites for more information:
Where you live (geography) matters. Some disease-causing fungi are more common in certain parts of the world. If you live in or visit these areas, you may be more likely to get these infections than the general population. For more information on travel-related illnesses, please see the CDC Traveler’s Healthsite.
Indoor mold. You may be at higher risk for getting sick from indoor mold. For more information about indoor mold, please visit CDC's Basic Facts about Mold.
CDC's lead group for the prevention and control of fungal infections in the United States and internationally through epidemiological and microbiological studies to improve the diagnosis, treatment, prevention, and control of mycotic diseases.
CDC's Mycotic Disease Branch (MDB) is dedicated to preventing death and disability due to fungal diseases. As one of the only public health groups in the world devoted specifically to the prevention and control of fungal infections, MDB works with domestic and international partners to determine the burden of fungal infections, respond to outbreaks, and to address public health problems related to fungal infections. Fungal diseases are a concern in the medical and public health community for several reasons[PDF - 2 pages]:
Our Branch is composed of three teams. Epidemiology and laboratory staff members work together to generate new information about the burden of fungal diseases and disease-causing fungi, detect and identify fungi in clinical samples, investigate the source of fungal outbreaks, conduct applied public health research, and provide training in the identification of medically important fungi.
Just like antibiotics cure bacterial infections, antifungal medications save lives by curing dangerous fungal infections. And just like some bacterial infections are resistant to antibiotics, some fungi no longer respond to the antifungal medications that are designed to cure them. This emerging phenomenon is known as antifungal resistance, and it’s primarily a concern for invasive infections with the fungus Candida but also Aspergillus.
Although antibiotic-resistant bacterial infections are a widely-recognized public health threat, less is known about the effects of antifungal resistance and the burden of drug-resistant fungal infections. This highlights the need for an improved understanding of the reasons for their emergence, heightened awareness among medical and public health communities about these infections, and greater attention to methods that can be used to prevent and control them.
Overall, most serious fungal infections are rare, but they do happen. They are most common among people with weak immune systems. People with certain health conditions may need to take medications with side effects that can weaken your immune system and put you at risk for fungal infections.
Specifically, corticosteroids and TNF (tumor necrosis factor) inhibitors are two types of medications that can increase your chances of getting a fungal infection.1
Some fungal infections can be serious, such as:
Other fungal infections, such as oral candidiasis (thrush), are usually not life threatening.11
Even though you’re staying in the hospital to get better, it’s possible to get an infection while you’re there. If you’re staying in the hospital for an injury or an illness, you may be at risk for getting a fungal infection, especially if you’re very sick or have a weak immune system. These types of infections are calledhealthcare-associated infections (HAIs).
Hospital staff and healthcare providers do everything they can to prevent HAIs, but some procedures and situations can increase your risk for fungal HAIs. The information provided below can help you understand your risk and help you be a safe patient while hospitalized.
Fungal infections can range from mild to life-threatening. Some fungal infections are mild skin rashes, but others can be deadly, like fungal pneumonia. Because of this, it’s important to get treatment as soon as possible to try to avoid serious infection.
Life-saving devices like central venous catheters (a special kind of IV tube) can increase your risk for fungal infection. During your hospital stay you may need a central venous catheter, which is a tube placed into a vein to give medications or liquids. This can make it easier for fungi to enter your body and increase your chances of getting a fungal bloodstream infection such as candidemia.1, 2
Disease-causing fungi can enter your body through cuts, wounds, and burns. Fungi naturally live on your skin and on healthcare workers’ hands. These fungi can enter your body through cuts and wounds and cause infection during a hospital stay, especially if your wounds are severe.3
Staying in the intensive care unit (ICU). If you’re in the ICU because you’re critically ill or injured, you’re likely to need life-saving devices or procedures that can put you at risk for fungal infections, particularly Candida and Aspergillus infections.4
Surgery can lead to infection. If you’ve had surgery, it’s possible to get a fungal infection in in the part of the body where the surgery took place. Surgical site infections are often caused by bacteria, but can also be caused by fungi.
Hospital construction. Hospital staff do everything they can to prevent fungal infections. Despite this, outbreaks of aspergillosis have happened among very sick patients staying at hospitals where there is ongoing construction or renovation.5 This is thought to be because construction stirs up the amount of fungal spores in the air.
As a person living with HIV/AIDS, you have many opportunities for a healthy and full life. You may also have some health challenges. One of those challenges is avoiding infections.
Many fungal infections are called opportunistic infections, which means that they usually affect people with weak immune systems. Because HIV weakens the immune system, you have a greater chance of getting some types of fungal infections, like cryptococcosis, coccidioidomycosis,histoplasmosis, and pneumocystis pneumonia (PCP).
As an organ transplant patient, you have new opportunities for a healthy and full life. You may also have some new health challenges. One of those challenges is avoiding infections. While anti-rejection medication helps your accept the new organ by lowering your body’s immune system response, it can also put you at greater risk for fungal infections.
The European Paediatric Mycology Network (EPMyN) was launched in 2014 to create a European platform for research and education in the field of Paediatric Mycology. Its aim is to increase the knowledge of the epidemiology and pathogenesis and to improve the management of invasive fungal infections in neonates and children.
The objectives of the EPMyN are:
Current activities are focussed on collecting the necessary information about the current management of invasive fungal infections in children and neonates from a large number of European centres. This information will be collected by an electronic survey and the data will be captured in the REDCap database. The results of this survey are expected to define specific areas of future research and will emphasize difficulties encountered in our daily practice which need to be addressed.
Our first post-graduate course in Paediatric Mycology is taking place on October 12-13, 2015 in Lisbon, Portugal (just after the Trends in Medical Mycology 2015). This post-graduate course specifically targets paediatric infectious diseases specialists, paediatric hemato-oncologists and immunologists, paediatric pulmonologists and neonatologists (and those in training).
Steering group: Adilia Warris (chair), Andreas Groll, Andrew Cant, Carlo Giaquinto, Elio Castagnola, Emmanuel Roilides, Irja Lutsar, Mike Sharland, Nigel Klein, Paolo Manzoni, Roger Brüggemann, Thomas Lehrnbecher.
Contact: Dr. Adilia Warris, University of Aberdeen, Aberdeen Fungal Group, Institute of Medical Sciences, Rm 4.23, Foresterhill, Aberdeen, AB25 2ZD, UK.
The UK Clinical Mycology Network (UKCMN) is a structured network of laboratories with a steering committee to guide and promote best practice in clinical mycology. This is achieved through regular meetings for all members, input into PHE UK Standards for Microbiology Investigations guidelines, and National Institute for Health & Care Excellence guidelines, and co-ordination of the following:
UKCMN’s functions are to:
To find out more, download the UKCMN constitution and terms of reference(PDF, 97.2KB, 2 pages) .
The Fungal Network of New Zealand (FUNNZ) is an independent non-profit incorporated mycological society open to anybody. FUNNZ organises an annual national fungal foray. The main objects of the Society are:
The advent of modern medicine plus AIDS has greatly increased the susceptible population for fungal infection world-wide. Autopsy studies in Europe have shown striking increases in invasive fungal infections, many of which are undiagnosed at death. New antifungal drugs are available, some with better safety profiles than amphotericin B, others with better efficacy but none with uniformly high cure rates. Multiple questions abound – including issues of pharmacodynamics, genetic predisposition, optimal diagnostics, altering epidemiology, combination therapy and many more.
This ESCMID Study Group brings together Europe’s top clinicians, diagnosticians and researchers in invasive fungal infections to create a geographically dispersed critical mass of expertise to address many of these questions.
Many of you will wonder what on earth your Council does for you and ISHAM. Here is a summary of the current Council’s aims and achievements
The current council set as its main priority tackling several recurring problems with the goal of creating a more streamlined, robust and efficient structure for future councils to be better able to represent the interests of the society.
We have by no means met all our goals but we are well on the way of achieving our ambition to secure a promising future for ISHAM in particular and the mycology community in general.
Aspergillus is intensively studied by a range of professional groups; medical, scientific, research, veterinary, taxonomists, genomists.
Some of these researchers are brought together in the Advances Against Aspergillosis meetings that occur once every two years (http://www.advancesagainstaspergillosis.org/) and we thought it would be worthwhile to provide this group to make contact between thses groups more easy between meetings.
Other groups are also welcome to join - all you need is an interest in Aspergillus.
The Aberdeen Fungal Group in partnership with Radboud University Nijmegen, Netherlands secured a Wellcome Trust Strategic Award worth £5.1 million, to establish and lead the Medical Mycology and Fungal Immunology Consortium.
The Consortium also comprises research expertise from Imperial College London and the Universities of Birmingham, Exeter, Glasgow, Kent, Manchester, Newcastle, Sheffield, King's College London, St George's University London and other UK institutions.
Specific Aims of the Consortium:
Aspergillus Website listing of all known mycological societies
The International Pediatric Fungal Network is a collaborative group of investigators and centers focused on pediatric invasive fungal infections. This Network is uniquely comprised of expert pediatric investigators dedicated to developing the optimal care for children with these life-threatening infections.
Our mission is to:
Duke University and The Children's Hospital of Philadelphia serve as the coordinating centers for the International Pediatric Fungal Network (IPFN).
Raising awareness of the good things that fungi do for all of us.
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