Prevention of fungal infections in hematology patients.
Endogenous infections such as candidiasis can be minimized by oral fluconazole prophylaxis, although oral or intravenous amphotericin, or itraconazole, are suitable for certain patients. Exogenous fungal infections most commonly are transmitted by the airborne route, but the benefits of high-efficiency particulate air-filtered room air probably are diminishing as broad-spectrum prophylaxis against Aspergillus species and other fungi improves. However, high-risk environmental sources such as construction work always must be avoided near neutropenic patients. Reactivation of quiescent pulmonary Aspergillus infection can be prevented by surgical resection during remission, or by systemic amphotericin prophylaxis during subsequent neutropenic episodes.
Philpott-Howard
J
J
Dulwich Public Health Laboratory and Medical Microbiology, Kings College School of Medicine and Dentistry, London, United Kingdom.
D006402:Hematologic Diseases / Q000150:complications / Q000276:immunology / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D017053:Infection Control; D009181:Mycoses / Q000150:complications / Q000517:prevention & control*; D009894:Opportunistic Infections / Q000382:microbiology / Q000517:prevention & control; D012307:Risk Factors