Diagnosis and Treatment of Fungal Infections

Dear Colleague,

Paradoxically, despite the progress in medicine, the prevalence of fungal infections is increasing each year, and the therapeutic measures available at the beginning of the third millennium are still highly limited. The first concerns about the increasing prevalence of fungal infections emerged in the first decades of the 20th century, ascribed to various environmental factors and anthropopressure. Consequently, the first therapeutic attempts to treat these infections were undertaken.

Although pathogenic fungi are one of the oldest groups of microorganisms, they were not part of any stable taxonomic system for a long time. Given the enormous number of taxonomic differences between related fungal pathogens and the importance of species-level identification, the gold standard to use for routine identification of dermatophytes has become the subject of an ongoing debate, and microbiologists' opinions are still inconsistent. Hence, currently reliable establishment of the boundaries of fungal species and, thus, accurate species identification require a multidirectional approach, as it is easy to make a mistake in diagnosis. The importance of correct identification of the etiological factor of mycosis is most clearly appreciated when treatment fails. However, the inefficiency of therapy applied in the course of fungal infections may have many more causes than only the wrong diagnosis.

Historically, the first antifungal drugs were limited to nonspecific agents, e.g., iodide, mercury, benzoic and salicylic acids, phenol derivatives, undecylenic acid, methyl violet, sulfonamide derivatives, and other factors, with usually harmful effects on human health such as preparations based on bromine, potassium permanganate, and turpentine oil mixed with olive oil. The interest in clinical antifungal therapy has gradually increased since then, although the rate of development of antifungal drugs has been very slow to date. Despite the availability of at least a few classes of antifungal drugs intended for clinical use, they have a limited spectrum of accessible cellular targets. Nowadays, the search for synthetic and natural chemical compounds that may constitute new therapeutic options due to their antifungal activity against pathogenic fungi fits in the concept of finding the “holy grail” in antifungal therapy. Another problem resulting from the widespread use of antifungal drugs, and related to the overlapping mechanisms of action and identical cellular targets, is the emergence of multidrug resistance (MDR) phenotypes in an increasing number of pathogenic fungi. Hence, in vitro tests of antifungal drugs and a description of the mechanisms contributing to this emerging resistance are the present tasks for the mycologist milieu.

In the context of the increase in new literature focused on the diagnostics and therapy of fungal infections, this Special Issue is being launched. The aim is to provide a single source to showcase the highlights of new and up-to-date research from all areas of clinical and veterinary diagnostics and therapy for fungal infectious disease.

Dr. Dominik Łagowski
Dr. Sebastian Gnat
Dr. Mariusz Dyląg
Dr. Aneta Nowakiewicz
Guest Editors

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