[Intra-abdominal mycoses].
The incidence of invasive mycoses in patients undergoing abdominal surgery amounts to approximately 8% and shows an upward trend in epidemiological studies. The lethality of these systemic mycoses, which are mostly based on Candida infections constitutes up to 60%. The development of a sytemic mycosis is marked by exogenic, endogenic and iatrogenic risk factors and typically displays tissue invasion after an initial fungal contamination or systemic dissemination via fungal sepsis. Fungal peritonitis is generally a monoinfection with Candida spp., where Candida albicans outweighs in 70% of cases. Aspergillus spp. are only detected abdominally in rare cases. The histological verification of a fungal invasion is regarded as proof of the existence of an invasive mycosis, but typical macroscopic findings with corresponding cultural findings can also confirm the diagnosis. Systemic mycosis requires an early initiation of a consistent antimycotic therapy as well as definitive surgical eradication of the focus in order to reduce high lethal rate. Resistances or incorrect dosages can be validated objectively by means of histological monitoring of the antimycotic therapy, thus affording early recognition of the need to change the substance class.
Boos
C
C
Klinik für Orthopädie, Universitätsklimikum Schleswig-Holstein-Campus Lübeck, Lübeck, Germany. carsten.boos@netsuf.de
Kujath
P
P
Bruch
H-P
HP
D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D001230:Aspergillus / Q000145:classification; D002176:Candida albicans; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012307:Risk Factors
D000935:Antifungal Agents