With increasing numbers of patients needing intensive care or who are immunosuppressed, infections caused by moulds other than Aspergillus spp or Mucorales are increasing. Although antifungal prophylaxis has shown effectiveness in preventing many invasive fungal infections, selective pressure has caused an increase of breakthrough infections caused by Fusarium, Lomentospora, and Scedosporium species, as well as by dematiaceous moulds, Rasamsonia, Schizophyllum, Scopulariopsis, Paecilomyces, Penicillium, Talaromyces and Purpureocillium species. Guidance on the complex multidisciplinary management of infections caused by these pathogens has the potential to improve prognosis. Management routes depend on the availability of diagnostic and therapeutic options. The present recommendations are part of the One World—One Guideline initiative to incorporate regional differences in the epidemiology and management of rare mould infections. Experts from 24 countries contributed their knowledge and analysed published evidence on the diagnosis and treatment of rare mould infections. This consensus document intends to provide practical guidance in clinical decision making by engaging physicians and scientists involved in various aspects of clinical management. Moreover, we identify areas of uncertainty and constraints in optimising this management.

随着需要重症监护或免疫抑制的患者数量的增加，除曲霉菌属或毛霉目外的霉菌引起的感染正在增加。尽管抗真菌预防在预防许多侵袭性真菌感染方面显示出有效性，但选择压力导致由镰刀菌属、Lomentospora和足放线菌属以及暗色霉菌属、Rasamsonia、裂褶菌属、帚霉属、拟青霉属、青霉属、Talaromyces和 Purpureocillium 引起的突破性感染增加。指导这些病原体引起的感染的复杂多学科管理有可能改善预后。管理途径取决于诊断和治疗选择的可用性。本建议是“一个世界-一个指南”倡议的一部分，该倡议将地区差异纳入罕见霉菌感染的流行病学和管理。来自24个国家的专家贡献了他们的知识，并分析了已发表的关于罕见霉菌感染诊断和治疗的证据。本共识文件旨在通过让参与临床管理各方面的医生和科学家参与，为临床决策提供实践指导。此外，我们确定了优化这种管理的不确定性和限制领域。