Invasive fungal infections in the ICU.
Invasive fungal infections are major causes of morbidity and mortality in critically ill patients. Foremost among these is invasive candidiasis. In recent years, invasive aspergillosis (IA) and zygomycosis have emerged as major problems in susceptible, critically ill patients. Risk factors for invasive fungal infections, including disrupted anatomic barriers, suppressed antifungal host responses, and exposure to potentially opportunistic fungi are common in critically ill patients. The expanded antifungal armamentarium and advent of rapid diagnostic techniques are altering the approach to invasive fungal infections in the intensive care unit (ICU). Herein, we review recent developments in the field of antifungal host defenses, the changing epidemiology of fungal infections in the ICU, the pharmacology of antifungal agents of importance to critically ill patients, and the evolving approaches to therapy in this setting.
Shoham
Shmuel
S
Section of Infectious Diseases, Washington Hospital Center, Washington, D.C., MedStar Research Institute, Washington, DC 20010, USA. Shmuel.Shoham@medstar.net
Marwaha
Shilpa
S
D000935:Antifungal Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy; D054884:Host-Pathogen Interactions; D006801:Humans; D007362:Intensive Care Units; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors
D000935:Antifungal Agents