Fungal infections in solid organ transplantation

Purpose of reviewEmerging and reemerging fungal infections in solid organ transplant recipients are increasing due to the increase of the population, success of antifungal prophylaxis, and new immunosuppressive treatments. The review aims to describe some of these fungal pathogens and their complex management. Recent findingsAn increase of potential fungal pathogens is being described in the solid organ transplant population and, consequently, a rise in the morbidity and mortality of these patients. Clinical trials, both in vivo and in vitro, are being performed to better elucidate clinical response to existing and novel antifungal agents. Most promising are the newer triazoles (voriconazole and posaconazole) and their use in combination with other drug modalities (echinocandins and terbinafine). At the same time, experience has provided some insight into new risk factors and the use of antifungal prophylaxis to minimize the development of fungal infections. SummaryInvasive fungal infections are increasing in solid organ transplant patients. The clinician providing care for this population group will need to have a heightened awareness of possible fungal pathogens to be able to initiate effective treatment early. With the lack of controlled clinical trials, physicians will also have to draw from previously described cases and in-vitro susceptibility testing to optimize therapy.