464. MSG-06: A Registry of 90 Cases of Phaeohyphomycosis
Session: Poster Abstract Session: Mucor, Fusarium, and other Filamentous Mycoses
Thursday, October 8, 2015
Room: Poster Hall
Background: Phaeohyphomycoses are infections caused by dematiaceous, or darkly pigmented fungi. These are rare and difficult to study in a systematic manner.

Methods: The Mycoses Study Group, an international consortium of experts in mycology, sought to develop a detailed case registry (administered via Fungiscope; Cologne, Germany) of these uncommon fungal infections, as well as a collection of corresponding clinical isolates for further study.

Results: Herein, we present the first 90 cases, collected from 13 sites in 3 countries (U.S.A., Australia, Peru). 54% of patients were male. The most common genus was Scedosporium (prolificans) (18 cases), followed by Alternaria (10), Curvularia (9), Exophiala (8), Exserohilum (4), Ochroconis (4) and Cladophialophora(3). Most (80%) had some form of chronic immunosuppression, primarily organ and stem cell transplantation. A variety of clinical syndromes were observed: 32 skin and soft tissue, 23 pulmonary, 14 disseminated infections, 12 sinusitis, 11 central nervous system, 9 bone/joint, along with 5 cases of endophthalmitis,  3 mycetoma, 2 endocarditis and 1 peritonitis (some patients had more than one site involved). Antifungal therapy was administered in 86% of cases, including voriconazole (37), lipid amphotericin B formulations (14), posaconazole (8) and itraconazole (14). Surgery was performed in 29 cases. Overall mortality was high through end of follow-up (31%), though only 13 patients were known to have died due to fungal infection. Follow-up ranged from 1-39 months (average 3 months).

Conclusion: We report the first such case registry of these mycoses in order to better understand and manage these rare infections.

Sanjay Revankar, MD1, John Baddley, MD2, Sharon Chen, PhD MD3, Maria Vehreschild, MD4, Kerstin Wahlers, MD4, Peter Pappas, MD2 and MSG-06 Study Investigators, (1)Infectious Diseases, Detroit Medical Center / Wayne State University, Detroit, MI, (2)Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, (3)Infectious Diseases and Microbiology, Westmead Hospital, Sydney, NSW, Australia, (4)Fungiscope/Uniklinik Koeln, Koeln, Germany


S. Revankar, Astellas: Investigator , Research grant
Merck: Investigator , Research grant
Gilead: Investigator , Research grant

J. Baddley, Pfizer: Consultant , Consulting fee
BMS: Grant Investigator , Research grant

S. Chen, Pfizer Australia: Grant Investigator and Investigator , Research support

M. Vehreschild, Pfizer: Speaker's Bureau , Speaker honorarium
Merck: Consultant and Speaker's Bureau , Consulting fee and Speaker honorarium
Gilead: Investigator and Speaker's Bureau , Research grant and Speaker honorarium
Astellas: Consultant , Investigator and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium
3M: Investigator , Research grant
DaVolterra: Consultant and Investigator , Consulting fee and Research grant
Berlin Chemie: Consultant , Consulting fee

K. Wahlers, Merck: Investigator and Speaker's Bureau , Research grant and Speaker honorarium
Astellas: Speaker's Bureau , Speaker honorarium
Gilead: Consultant , Travel grants

P. Pappas, Merck: Investigator , Research grant
Astellas: Investigator , Research grant
Gilead: Investigator , Research grant

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.