Pancreatic fungal infection.
BACKGROUND
There has been a steady rise in the incidence of pancreatic fungal infections. Even though fungal infections of the pancreas are not very common, they are often nosocomial.


OBJECTIVE
To review pancreatic fungal infections and to compare their clinical characteristics with those of bacterial pancreatic infections, along with the causes and approaches to diagnosis and treatment.


RESULTS
Because of the lack of randomized, prospective trials, standardized recommendations for use of antifungal prophylaxis would be premature. The most important aspect of prophylaxis against pancreatic fungal infection is minimizing the factors that predispose the pancreas to fungal infections.


CONCLUSIONS
Isolation of fungal elements from necrotic pancreatic tissue and treatment of local infection are vital. Treatment of local candidal infection should be initiated with surgical necrosectomy. Systemic antifungal therapy should be started early in the course of the disease, but whether antifungal agents should be added to the prophylactic antibiotic regimens for patients with necrotizing pancreatitis remains questionable.
Shanmugam
Nirmala
N
University of Miami School of Medicine and Division of Gastroenterology, Mount Sinai Medical Center, Miami, Florida 33140, USA.
Isenmann
Rainer
R
Barkin
Jamie S
JS
Beger
Hans G
HG
D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome
D000935:Antifungal Agents; D015725:Fluconazole