[Invasive fungal disease in hemato-oncological and hematopoietic stem cell transplantation patients from Hospital Clinico Universidad Católica, Santiago-Chile using revised EORTC/MSG diagnostic criteria].
BACKGROUND
Invasive fungal disease (IFD) is a severe complication occurring mostly in haematooncological (H-O) patients and hematopoietic stem cell transplant (HSCT) receptors. Our aim was to describe the IFD occurring in our H-O and HSCT patients according to the EORTC/MSG revised criteria.


METHODS
IFD surveillance was performed in adult patients of the Hospital Clínico Universidad Catolica, Santiago, Chile, from January 2004 to January 2008.


RESULTS
A total of 41 IFD episodes were identified in 39 patients; mean age was 46.6 +/- 9.9 years, and 87.8% and 12.2% occurred in H-O and HCTS patients respectively. 15/41(36.6%) episodes were proven, 36.6% probable and 11/41 (26.8%) possible. In 26 (63.4%) episodes aspergillosis was diagnosed (20 pulmonary, 3 sinus, 1 laryngeal and 1 case with pulmonary and cerebral involvement). In 7 patients (17.1%) candidiasis was diagnosed, 5 with a proven bloodstream infection and 2 with possible hepatosplenic candidiasis; mucormyeosis was diagnosed in 4 (9.8%) Fusarium infection was demonstrated in 2 patients (4.9%), and Mucor and Aspergillus pulmonary coinfection and Alternaria sp rhino-sinusitis in one patient each. The frequency of IFD among febrile neutropenic patients was 26.2% and 6.4% in H-O and HSCT receptors respectively. The overall mortality was 36%.


CONCLUSIONS
Aspergillosis is the most common IFD infection among H-O patients and HSCT receptors in our center. Candidiasis followed although only in H-O patients most probably because of routine use of antifungal prophylaxis in HSCT recipients. Continuous surveillance is required to develop local guidelines and to evaluate antifungal strategies in different clinical scenarios.
Rabagliati B
Ricardo
R
Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Fuentes L
Gino
G
Guzmán D
Ana María
AM
Orellana U
Eric
E
Oporto C
Jorge
J
Aedo C
Igor
I
Garrido S
Marcelo
M
Nervi N
Bruno
B
D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007938:Leukemia / Q000628:therapy*; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology*