Fungal infections in nontransplant patients with hematologic malignancies

Infect Dis Clin North Am. 2002 Dec;16(4):935-64, vii. doi: 10.1016/s0891-5520(02)00043-0.

Abstract

Fungal infections are a major cause of morbidity and mortality in patients with hematologic malignancies. Candida and Aspergillus species are the most important opportunistic fungal pathogens in this patient population. Dimorphic fungi can cause serious infection in immunocompetent persons, but infection is more likely to be disseminated in patients with compromised cell-mediated immunity. Cryptococcus neoformans and Pneumosystis carinii typically cause infections in persons with severe T-cell suppression. The frequency of rare pathogenic fungi commonly resistant to amphotericin B has significantly increased over the past 20 years among patients with hematologic malignancies. Examples of such emerging pathogens include Trichosporon, Fusarium, and Scedosporium species, and dark-walled molds. This article reviews the epidemiology, clinical manifestations, diagnostic evaluation, and treatment of the major fungal pathogens in nontransplant patients with hematologic malignancies.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / administration & dosage
  • Antifungal Agents / adverse effects
  • Antifungal Agents / therapeutic use
  • Bone Marrow Transplantation / immunology
  • Cytokines / therapeutic use
  • Drug Therapy, Combination
  • Granulocyte-Macrophage Colony-Stimulating Factor / pharmacology
  • Hematologic Neoplasms / complications*
  • Humans
  • Immunocompromised Host
  • Mycoses* / complications
  • Mycoses* / diagnosis
  • Mycoses* / drug therapy
  • Mycoses* / epidemiology
  • Neutropenia / complications
  • Neutropenia / drug therapy
  • Neutrophils / physiology
  • Opportunistic Infections / complications
  • Opportunistic Infections / drug therapy
  • Risk Factors

Substances

  • Antifungal Agents
  • Cytokines
  • Granulocyte-Macrophage Colony-Stimulating Factor