Pulmonary fungal infections.
OBJECTIVE
Invasive fungal infections of the lung have historically been associated with an extremely high mortality. This review aims to disseminate the most recent advances in the diagnosis and management of fungal infections of the lung.


RESULTS
The number and diversity of immunosuppressed populations are growing rapidly. Transplant immunosuppression is becoming more aggressive early in the posttransplant period, potentially increasing the risk of invasive fungal infections. The galactomannan antigen test and the beta-D-glucan test have emerged as methods of serially monitoring at-risk patients for invasive aspergillosis. Their utility has been established in some neutropenic populations but not in solid organ transplant recipients. In-vitro studies, animal studies, and retrospective human studies support the use of combination antifungal therapy for invasive aspergillosis. Unfortunately no randomized clinical trials exist.


CONCLUSIONS
Invasive pulmonary aspergillosis will continue to be a major problem in immunocompromised patients in the future. Immense advances in the last 2-3 years are sure to improve outcome. Well-designed multicenter evaluations are still necessary, however, to optimize management as management options widen.
Silveira
Fernanda
F
Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Paterson
David L
DL
D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D000935:Antifungal Agents