With increasing numbers of patients needing intensive care or who are immunosuppressed, infections caused by moulds other than Aspergillus spp or Mucorales are increasing. Although antifungal prophylaxis has shown effectiveness in preventing many invasive fungal infections, selective pressure has caused an increase of breakthrough infections caused by Fusarium, Lomentospora, and Scedosporium species, as well as by dematiaceous moulds, Rasamsonia, Schizophyllum, Scopulariopsis, Paecilomyces, Penicillium, Talaromyces and Purpureocillium species. Guidance on the complex multidisciplinary management of infections caused by these pathogens has the potential to improve prognosis. Management routes depend on the availability of diagnostic and therapeutic options. The present recommendations are part of the One World-One Guideline initiative to incorporate regional differences in the epidemiology and management of rare mould infections. Experts from 24 countries contributed their knowledge and analysed published evidence on the diagnosis and treatment of rare mould infections. This consensus document intends to provide practical guidance in clinical decision making by engaging physicians and scientists involved in various aspects of clinical management. Moreover, we identify areas of uncertainty and constraints in optimising this management.

Center of Expertise in Mycology Radboud University Medical Center Canisius Wilhelmina Hospital Nijmegen Netherlands

Centre for Cardiovascular Surgery and Transplantation and Faculty of Medicine Masaryk University Brno Czech Republic

Critical Care Department Attikon University Hospital National and Kapodistrian University of Athens Greece

Department of Clinical Microbiology Trinity College Dublin St James's Hospital Campus Dublin Ireland

Department of Hematology and Oncology University Hospital Mannheim Heidelberg University Mannheim Germany

Department of Internal Medicine Federal University of Rio de Janeiro Rio de Janeiro Brazil

Department of Laboratory Medicne and Pathology Hamad Medical Corporation Doha Qatar

Department of Medical Microbiology and Infectious Diseases Radboud University Medical Center Canisius Wilhelmina Hospital Nijmegen Netherlands; Center of Expertise in Mycology Radboud University Medical Center Canisius Wilhelmina Hospital Nijmegen Netherlands; European Confederation of Medical Mycology Council Basel Switzerland

Department of Medical Mycology Vallabhbhai Patel Chest Institute University of Delhi Delhi India

Department of Medicine Department of Pediatrics and Department of Microbiology and Immunology Weill Cornell Medicine New York NY USA; New York Presbyterian Hospital Weill Cornell Medical Center New York NY USA

Department of Microbiology Amrita Institute of Medical Sciences and Research Centre Amrita Vishwa Vidyapeetham Kochi India

Department of Microbiology Faculty of Medicine and Dentistry University Hospital Olomouc Palacky University Olomouc Olomouc Czech Republic; European Confederation of Medical Mycology Council Basel Switzerland

Department of Microbiology Natural and Medical Sciences Research Center University of Nizwa Nizwa Oman

Department of Microbiology University of Colombo Colombo Sri Lanka

Department of Microbiology University of Hong Kong Hong Kong China

Department of Parasitology Faculty of Medicine Universitas Indonesia Jakarta Indonesia; Department of Parasitology Faculty of Medicine Universitas Kristen Indonesia Jakarta Indonesia

Department of Pediatrics and Pediatric Oncology Institute IOP GRAACC UNIFESP Federal Univeristy of São Paulo São Paulo Brazil

Department of Public Health Clinics Hospital Federal University of Parana Curitiba Brazil

Division of Infection Immunity and Respiratory Medicine University of Manchester Manchester UK; Mycology Reference Centre Manchester Manchester University NHS Foundation Trust Manchester UK

Division of Infections Diseases Department of Health Sciences IRCCS San Martino Polyclinic Hospital University of Genoa Genoa Italy

Division of Infectious Diseases and Global Public Health Department of Medicine University of California San Diego San Diego CA USA; Clinical and Translational Fungal Research Working Group University of California San Diego San Diego CA USA; Division of General Internal Medicine Department of Medicine University of California San Diego San Diego CA USA

Division of Infectious Diseases University of Toronto Toronto ON Canada

Division of Infectious Diseases Wayne State University Detroit MI USA

Division of Pediatric Hematology and Oncology Hospital for Children and Adolescents University Hospital Frankfurt Germany

Faculty of Medicine University of Cologne Cologne Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases University of Cologne Cologne Germany

Faculty of Medicine University of Cologne Cologne Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases University of Cologne Cologne Germany; Clinical Trials Center Cologne University of Cologne Cologne Germany; German Centre for Infection Research partner site Bonn Cologne Cologne Germany; European Confederation of Medical Mycology Council Basel Switzerland

Faculty of Medicine University of Cologne Cologne Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases University of Cologne Cologne Germany; German Centre for Infection Research partner site Bonn Cologne Cologne Germany

Faculty of Medicine University of Cologne Cologne Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases University of Cologne Cologne Germany; German Centre for Infection Research partner site Bonn Cologne Cologne Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany

Faculty of Medicine University of Cologne Cologne Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases University of Cologne Cologne Germany; Medical Center Hamburg Eppendorf University of Hamburg Hamburg Germany

Faculty of Medicine University of Cologne Cologne Germany; German Centre for Infection Research partner site Bonn Cologne Cologne Germany

Faculty of Pharmacy and Collaborative Drug Discovery Research Group Pharmaceutical and Life Sciences Community of Research Universiti Teknologi MARA Selangor Malaysia

Host Pathogen Interaction Study Group and Laboratory of Parasitology and Mycology Angers University Hospital Angers University Angers France

Institute of Hygiene and Medical Microbiology Department of Hygiene Medical Microbiology and Publics Health Medical University Innsbruck Innsbruck Austria

Medical Research Council Centre for Medical Mycology University of Exeter Exeter UK

National Institute for Medical Research Tanzania; Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania; Nelson Mandela African Institution of Science and Technology Arusha Tanzania; Department of International Public Health Liverpool School of Tropical Medicine Liverpool UK

National Reference Laboratory for Medical Mycology Institute of Microbiology and Immunology Faculty of Medicine University of Belgrade Belgrade Serbia; European Confederation of Medical Mycology Council Basel Switzerland

Section of Infectious Diseases and Tropical Medicine Medical University of Graz Graz Austria

Section of Infectious Diseases and Tropical Medicine Medical University of Graz Graz Austria; Division of Infectious Diseases and Global Public Health Department of Medicine University of California San Diego San Diego CA USA; Clinical and Translational Fungal Research Working Group University of California San Diego San Diego CA USA; European Confederation of Medical Mycology Council Basel Switzerland

Sheba Medical Center and Sackler School of Medicine Tel Aviv University Tel Aviv Israel

University Hospital Puerta de Hierro Majadahonda Madrid Spain

University of Melbourne Melbourne VIC Australia; National Centre for Infections in Cancer Peter MacCallum Cancer Centre Melbourne VIC Australia

University of Minnesota Minneapolis MN USA

UT Health San Antonio and South Texas Veterans Health Care System San Antonio TX USA

Komentář v

mBio. 2021 Feb 23;12(1):e02920-20. doi: 10.1128/mBio.02920-20. PubMed

Erratum v

Lancet Infect Dis. 2021 Apr;21(4):e81. doi: 10.1016/S1473-3099(21)00124-9. PubMed

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