Dark Mold Infections in Solid Organ Transplant Recipients

Purpose of Review Solid organ transplant (SOT) recipients are a high-risk population for invasive fungal infections. While infections with black molds are rare in SOT recipients, they are important to consider since morbidity and mortality are high, and the treatment may differ substantially from other more common invasive fungal infections. Recent Findings The incidence of black molds tends to be increasing. While the backbone of diagnosis remain traditional tools like histopathology and culture, the rapid evolution of non-culture-based methods for molecular detection promises improved identification of these rare fungi. While for many of those rare fungal infections liposomal amphotericin B remains the treatment of choice, mold active triazoles are the backbone for treatment of scedosporiosis and lomentosporiosis. New antifungal agents like ibrexafungerp, olorofim, and fosmanogepix may provide additional treatment options for the future. Summary In this paper, we review infections caused by black molds in SOT recipients. The focus lies on epidemiology, diagnostic work-up, and antifungal treatment.