Invasive Mold Infections in Solid Organ Transplant Recipients

Table 1

Epidemiology, clinical and imaging findings among SOT recipients with invasive mold infection.

	Aspergillosis	Scedosporium	Fusariosis	Mucormycosis	Phaeohyphomycosis
Epidemiology [2, 8]
Number (%) among proven; or probable IFIs in SOT recipients	227/1208 (18.8%)	11/1208 (0.9%)	6/1208 (0.5%)	28/1208 (2.3%)	NA (<5%)
12 months of cumulative incidence	0.7%; Lung 4.13%	0.024%; Lung 0.2%; kidney 0.01%	0.012%; 1 Lung 0.08%; 1 Liver 0.02%	0.07%; Lung 0.18%; Liver 0.16%; Early onset (<90 d) for liver; Late onset for lung (>90 d)	0.7% overall CI; Lung 1.4%; Heart 1.2%; Kidney 1%; Liver 0.16%; Kidney/pancreas 3.6%
Median time to IMI, days	184	467	467	312	700
Common species [2, 8, 14, 25, 44]	A.  fumigatus 60–73%; A.  flavus 7–10%; A.  niger 6–9%	S. apiospermum 55%; S. prolificans 45%	Unspecified 45–50%; F. solani 17–35%; F. proliferatum 0–10%; F. oxysporum0–33%	Rhizopus 57–73%; Mucor (13–25%); Lichtheimia (0–4%); Cunninghamella (0–14%)	Exophiala jeanselmei & sp. 41%; Ochroconis gallopava11%; Alternaria species 11%; Phoma species 11%
Clinical findings [2, 8, 14, 44, 57, 125]			–20	8–116
Sinus (%)	4	4	0–18	13–31	rare
Lung (%)	78 (tracheobronchial 5%)	52	39–45	22–56	7
Skin (%)	4	21	45–70 (including onychomycosis)	13–15	89
CNS (%)	2	49	rare	14 (rhinocerebral)	7
Disseminated (%)	10	35 (30% of intravascular infection)	25	9–12% (including gastrointestinal)	4%
Lung CT findings^*; [40, 63, 126–129]	In nonneutropenic patient: Airway invasive pattern: Peribronchial consolidation (31%); Ground-glass opacity (38%); Angioinvasive pattern: Macronodules (35%); Mass-like consolidation (27%); Halo signs (8%); Air-crescent signs (0%); Reversed halo sign (<1%)	In HM: Multiple bilateral patchy nodular condensations, alveolar infiltrates or, most commonly, consolidation without cavitation	In HM: Pulmonary nodules in 82%; Reversed halo sign 0%; Halo sign <20%!	in HM: Focal consolidation, masses, pleural effusions, or multiple nodules; Reversed halo sign (19%); Among patients with HM, predictors of mucormycosis versus IPA are concomitant sinusitis, >10 pulmonary nodules on CT scan, and pleural effusion	NA

CI: cumulative incidence; HM: patients with hematological malignancies; IMI: invasive mold infection; NA: not available.
^*No specific data among SOT except for invasive aspergillosis.