Fungal infections in nontransplant patients with hematologic malignancies.
Fungal infections are a major cause of morbidity and mortality in patients with hematologic malignancies. Candida and Aspergillus species are the most important opportunistic fungal pathogens in this patient population. Dimorphic fungi can cause serious infection in immunocompetent persons, but infection is more likely to be disseminated in patients with compromised cell-mediated immunity. Cryptococcus neoformans and Pneumosystis carinii typically cause infections in persons with severe T-cell suppression. The frequency of rare pathogenic fungi commonly resistant to amphotericin B has significantly increased over the past 20 years among patients with hematologic malignancies. Examples of such emerging pathogens include Trichosporon, Fusarium, and Scedosporium species, and dark-walled molds. This article reviews the epidemiology, clinical manifestations, diagnostic evaluation, and treatment of the major fungal pathogens in nontransplant patients with hematologic malignancies.
Segal
Brahm H
BH
Division of Infectious Diseases, SUNY at Buffalo, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA. brahm.segal@roswellpark.org
Bow
Eric J
EJ
Menichetti
Francisco
F
D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000276:immunology; D016207:Cytokines / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D009181:Mycoses / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy; D009504:Neutrophils / Q000502:physiology; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy; D012307:Risk Factors
D000935:Antifungal Agents; D016207:Cytokines; D016178:Granulocyte-Macrophage Colony-Stimulating Factor