Invasive Mold Infections in the Tertiary Center: Expert Guidance on Diagnosis and Management

0.75 CME
$0 FEE


This educational activity is jointly provided by Postgraduate Institute for Medicine and Spire Learning.


This activity is supported by an educational grant from Astellas Pharma Global Development, Inc.

Release Date: 5/2/2019
Expiration Date: 5/2/2020
Estimated time to complete activity: 45 minutes

Invasive mold infections are a significant cause of morbidity and mortality due to the increasing population of immunocompromised patients and newly identified risk factors beyond malignancy and immunosuppression. Through real-world case studies and discussion, Dr Peter Pappas and Dr Stephen Threlkeld will address the key challenges faced by infectious disease specialists and hospitalists in academic and tertiary centers, including: shifting trends in the fungal landscape with a focus on Aspergillus spp. and Mucorales; risk factors in the immunocompromised population; challenges to and improvements in diagnosis; and the importance of prompt, informed, empiric antifungal therapy according to available guidelines and newer clinical trial data.


  • Physicians, including infectious disease specialists, hospitalists, and intensivists.

Upon completion of this activity, the participant should be better able to:

  • Match patients for whom empiric treatment is warranted with appropriate antifungal therapies 
  • Apply best practices for identification of pathogenic fungi and select targeted therapy 
  • Select treatment modification strategies based on clinical and laboratory findings

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Spire Learning. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Your points will be automatically submitted to the ABIM on your behalf; please allow 6-8 weeks for your points to display on the ABIM website.

CLAIMING MOC POINTS: If you intend to claim MOC points for your participation, you will need to provide your unique, ABIM ID when completing the activity evaluation. Physicians who do not know their ABIM ID can log in to the ABIM website at — your ABIM ID will appear next to your name.

There is no fee to participate in this activity. In order to receive CME credit, you must:

  • Complete the preassessment questions prior to the start of the activity
  • Participate in the activity 
  • Complete the postassessment (achieving a passing score of 75%) and evaluation at the end of the activity

For questions about the accreditation of this activity, please contact Postgraduate Institute for Medicine at: or (303) 799-1930.

For questions about the content of this activity, please contact:

For technical questions, please contact:

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management.  Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA, including caspofungin and posaconazole. The planners of this activity do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

Peter G. Pappas, MD 

Contracted Research: Astellas Pharma; Cidara Therapeutics, Inc; Gilead Sciences, Inc; IMMY; Merck & Company, Inc; Scynexis, Inc

Stephen C. Threlkeld, MD
No relevant financial relationships with any commercial interests.

Dr Threlkeld is a Member of the ABIM Infectious Disease Board Exam Committee. To protect the integrity of certification, ABIM enforces strict confidentiality and ownership of exam content. As a Member of the Infectious Disease Board Exam Committee, Dr Threlkeld agrees to keep exam information confidential. As is true for any ABIM candidate who has taken an exam for certification, Dr Threldkeld has signed a Pledge of Honesty in which he has agreed to keep ABIM exam content confidential. No exam questions will be disclosed in his presentation.

In order to resolve conflict of interest, presentations of this activity were peer reviewed by an independent reviewer. The reviewer has no relationship with a commercial interest. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

Peer reviewers: No real or apparent conflicts of interest to report. 


Postgraduate Institute for Medicine 
The PIM planners and managers have nothing to disclose. 

Spire Learning
Christine Kocienda and Cara U, PharmD: No relevant financial relationships with any commercial interests.

Levels of evidence are provided for any patient care recommendations made during this educational activity.

Level A (randomized controlled trial/meta-analysis): High-quality, randomized controlled trial (RCT) that considers all important outcomes. High-quality meta-analysis (quantitative systematic review) using comprehensive search strategies

Level B (other evidence): A well-designed, nonrandomized clinical trial. A nonquantitative systematic review with appropriate search strategies and well-substantiated conclusions. Includes lower-quality RCTs, clinical cohort studies and case-controlled studies with nonbiased selection of study participants and consistent findings. Other evidence, such as high-quality, historical, uncontrolled studies, or well-designed epidemiologic studies with compelling findings, is also included

Level C (consensus/expert opinion): Consensus viewpoint or expert opinion

Each rating is applied to a single reference in the presentation, not the entire body of evidence on the topic.

Peter G. Pappas, MD

Professor of Medicine
Department of Medicine, Division of Infectious Diseases
University of Alabama at Birmingham School of Medicine
Birmingham, AL  

Dr Peter G. Pappas is Professor of Medicine in the Division of Infectious Diseases at the University of Alabama at Birmingham School of Medicine, where he also holds the William E. Dismukes Endowed Professorship in Infectious Diseases. Dr Pappas received his medical degree from the University of Alabama at Birmingham School of Medicine, and then completed his residency and fellowship in infectious diseases at the University of Washington in Seattle. He is a fellow of the American College of Physicians and a board-certified infectious diseases specialist. Dr Pappas is actively involved at the University of Alabama Hospital, where he serves as an attending physician, scientist for the cancer center and AIDS center, founder of the Transplant Infectious Diseases Initiative, and chair of the Antimicrobial Stewardship Committee. 

Dr Pappas’s research focuses on transplant-associated infections, with an interest in diagnosis, epidemiology, and new therapeutic approaches for invasive candidiasis, cryptococcosis, aspergillosis, sporotrichosis, blastomycosis, and histoplasmosis. He is currently the principal investigator for the Mycoses Study Group Education and Research Consortium (MSGERC). In addition, he currently serves on the World Health Organization Cryptococcal Treatment Guidelines Committee and the US Public Health Service/Infectious Diseases Society of America Guidelines Committee for Prevention and Treatment of Opportunistic Infections during HIV Infection. His research has led to almost 200 abstract presentations at infectious disease meetings worldwide and an additional 200 publications in peer-reviewed journals such as New England Journal of Medicine, Clinical Infectious Diseases, and Transplant Infectious Disease. Dr Pappas has served as Associate Editor of Clinical Infectious Diseases since 2017. 

Stephen C. Threlkeld, MD
Infectious Disease Specialist 
Threlkeld, Threlkeld & Omer, PLLC 
Memphis, TN

Dr Stephen C. Threlkeld is an infectious disease specialist and managing partner at Threlkeld, Threlkeld & Omer, PLLC in Memphis, Tennessee. In addition, he is Clinical Assistant Professor of Medicine at the University of Tennessee Health Sciences Center. He received his medical degree from the University of Alabama School of Medicine in Birmingham, where he also completed his internal medicine residency. Dr Threlkeld completed further postgraduate training in Boston, Massachusetts, as a clinical fellow in infectious disease at Massachusetts General Hospital, then as a research fellow at Harvard Medical School. While at Massachusetts General Hospital, he received the Edward H. Kass Award for Clinical Excellence.

Dr Threlkeld is actively involved at Baptist Memorial Hospital in Memphis, where he is current Chair of the Metro Credentials Committee, epidemiologist for the Baptist Memorial Stem Cell Transplant Program and Baptist Restorative Care Hospital, co-chairman of the Infection Control Committee, infectious disease consultant and epidemiologist for the Baptist Memorial Hospital Cardiac Transplant Program, and co-chairman of the Antibiotic Stewardship Committee. He also served as a member of the Baptist Memorial Metropolitan Board of Trustees from 2015 to 2018. Dr Threlkeld is jointly appointed at Methodist Healthcare Hospital and Saint Francis Hospital, both located in Memphis. He has authored multiple book chapters and articles in peer-reviewed journals including The Journal of Infectious Diseases, The Journal of Immunology, The Journal of Virology, and Medical Clinics of North America. Additionally, Dr Threlkeld is a member of the Infectious Diseases Society of America and is on the Infectious Disease Test Committee of the American Board of Internal Medicine.