PDF(Pubmed)
Abstract：
Emergomycosis is an endemic mycosis caused by the Emergomyces species. Infections due to this agent have been reported globally. Hence, the present systematic review on Emergomyces infections was conducted to study the disease epidemiology, underlying diseases and risk factors, causative agents, and treatment and outcome. The MEDLINE, Scopus, Embase, and Web of Science databases were searched systematically with appropriate keywords from January 1990 to October 2022. A total of 77 cases of emergomycosis were included in the analysis. Emergomycosis was most commonly seen in patients with human immunodeficiency virus (HIV) infection (n = 61, 79.2%) and HIV-uninfected patients with or without other comorbidities (n = 16, 20.8%). The underlying disease and risk factors significantly associated with emergomycosis in the HIV-infected patients were CD4+ T-cell counts less than 100 cells/mm3 (n = 55, 90.2%), anaemia (n = 30, 49.2%), and thrombocytopenia (n = 17, 27.9%), whereas in the HIV-uninfected patients, treatment with immunosuppressive drugs (n = 10, 62.5%), renal disease (n = 8, 50%), transplant recipients (n = 6, 37.5%), and diabetes mellitus (n = 4, 25%) were the significant risk factors associated with emergomycosis. Emergomyces africanus (n = 55, 71.4%) is the most common causative agent, followed by E. pasteurianus (n = 9, 11.7%) and E. canadensis (n = 5, 6.5%). E. africanus was most often isolated from HIV-infected patients (n = 54, 98.2%), whereas E. pasteurianus was most common in HIV-uninfected patients (n = 5, 55.6%). The all-cause mortality rate of the total cohort is 42.9%. No significant variation in the mortality rate is observed between the HIV-infected patients (n = 28, 36.4%) and the HIV-uninfected patients (n = 5, 6.5%). In conclusion, with an increase in the immunosuppressed population across the globe in addition to HIV infection, the case burden of emergomycosis may increase in the future. Hence, clinicians and mycologists should be vigilant and clinically suspicious of emergomycosis, which helps in early diagnosis and initiation of antifungal treatment to prevent disease mortality.
摘要：
Emergomycosis是由Emergomes物种引起的地方性真菌病。由于该试剂引起的感染已在全球范围内报道。因此，本系统综述对胚胎属感染进行了研究，以研究疾病流行病学，潜在的疾病和危险因素，病原体，治疗和结果。MEDLINE,Scopus,Embase,从1990年1月到2022年10月，使用适当的关键词系统地搜索了WebofScience数据库。共纳入77例毛菌病病例分析。在患有人类免疫缺陷病毒（HIV）感染的患者（n=61，79.2％）和患有或不患有其他合并症的未感染HIV的患者（n=16，20.8％）中最常见病。在HIV感染患者中，潜在的疾病和危险因素显著相关的是CD4+T细胞计数小于100细胞/mm3（n=55，90.2%），贫血（n=30，49.2%），和血小板减少症（n=17，27.9%），而在未感染艾滋病毒的患者中，用免疫抑制药物治疗（n=10，62.5%），肾脏疾病（n=8，50%），移植受者（n=6，37.5%），糖尿病（n=4，25％）是与emergomycosis相关的重要危险因素。非洲胚(n=55,71.4%)是最常见的病原体,其次是E.pasteurianus（n=9，11.7％）和E.canadensis（n=5，6.5％）。最常分离自HIV感染患者（n=54，98.2%），而E.pasteurianus在未感染HIV的患者中最常见(n=5,55.6%)。整个队列的全因死亡率为42.9%。在HIV感染患者（n=28，36.4％）和未感染HIV的患者（n=5，6.5％）之间没有观察到死亡率的显着差异。总之,随着全球除艾滋病毒感染外，免疫抑制人口的增加，在未来可能会增加的病例负担。因此，临床医生和真菌学家应保持警惕，并在临床上怀疑是否有真菌病，这有助于早期诊断和开始抗真菌治疗，以防止疾病死亡。
