Antifungal stewardship with an emphasis on candidaemia.

Antimicrobial resistance is a global threat. To counter the growing menace of antibiotic resistance, several stewardship initiatives have been incorporated as part of the overarching strategy of healthcare delivery. In contrast, antifungal stewardship (AFS) has attracted less attention for several reasons, such as limited antifungal resistance and the lesser burden of fungal infections compared with bacterial infections.

Complications and outcomes of trimethoprim-sulphamethoxazole as chemoprophylaxis for pneumocystis pneumonia in renal transplant recipients.

Background: Following a pneumocystis pneumonia (PCP) outbreak in our nephrology unit, all transplant patients were offered chemoprophylaxis with trimethoprim-sulphamethoxazole (TMP-SMX) as the first line agent. A high rate of complications was noted. We aimed to quantify TMP-SMX associated adverse events and evaluate its prophylactic benefit in their light.

Aspergillosis sinusitis with cranio-orbital spread in an apparently immunocompetent patient.

Intracranial fungal infections are unusual and typically described in immunocompromised hosts. The authors describe a rare case of an immunocompetent white man presenting with blindness after Aspergillus fumigatus infection of the ethmoidal air sinus with spread to the orbital apex and the frontal lobe. This was successfully treated by surgical drainage via a frontal craniotomy and long-term antifungal therapy with voriconazole.

Real time presence of a microbiologist in a multidisciplinary diabetes foot clinic.

Multidisciplinary foot-care teams (MDFT) are recommended in the management of severe diabetic foot disease [1]. However, even though infection is often the dominant immediate risk, it is rare to have real time input from a microbiologist. We highlight the value of a microbiologist as a MDFT member.

Aspergillus fumigatus: a potentially lethal ubiquitous fungus in extremely low birthweight neonates.

Although Aspergillus fumigatus infection is relatively rare, it should be considered in preterm low birthweight neonates with a rapidly progressive purpuric rash. Prompt diagnosis and treatment is crucial to maximize the chances of survival.