<i>Exophiala</i> Bloodstream Infections in Humans—A Narrative Review
<b>Background:</b> <i>Exophiala</i> spp. are dematiaceous fungi with opportunistic pathogenic potential and a widespread environmental presence. Clinical cases of <i>Exophiala</i> spp. fungemia are uncommon. Although rarely encountered in the general population, t...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-07-01
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| Series: | Pathogens |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-0817/14/7/706 |
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| Summary: | <b>Background:</b> <i>Exophiala</i> spp. are dematiaceous fungi with opportunistic pathogenic potential and a widespread environmental presence. Clinical cases of <i>Exophiala</i> spp. fungemia are uncommon. Although rarely encountered in the general population, these organisms are increasingly reported in immunocompromised individuals or those with complex underlying health conditions. <b>Objectives:</b> This review seeks to examine all documented human cases of <i>Exophiala</i> spp. fungemia, with particular focus on aspects such as epidemiology, microbiological features, resistance patterns, therapeutic approaches and associated mortality rates. <b>Methods:</b> A narrative review was conducted using data sourced from the PubMed/MedLine and Scopus databases. <b>Results:</b> A total of 19 articles described infections in 32 patients involving <i>Exophiala</i> spp. fungemia. The mean patient age was 49.2 years, and 65.6% were male. Central venous catheters emerged as the leading predisposing factor (96.9%). Fever represented the most frequent clinical presentation (50%), followed by organ dysfunction (21.9%). The yeast generally demonstrated susceptibility to voriconazole and itraconazole. Voriconazole was also the most frequently administered antifungal (62.5%), followed by amphotericin (31.3%) and micafungin (28.1%). Overall mortality reached 34.4%, with 25% of deaths specifically caused by the infection. <b>Conclusions:</b> Given the potential of <i>Exophiala</i> spp. to cause severe fungemia, healthcare professionals, particularly clinicians and microbiologists, should consider this pathogen in the differential diagnosis when black yeast is detected in blood cultures, especially in patients with immunodeficiency or significant comorbidities, to ensure timely and accurate identification. |
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| ISSN: | 2076-0817 |