Diagnosis and treatment of fungal infections in oncohematology

Abstract

The incidence of systemic fungal infections has increased during the past years. The risk for fungal infection and mortality rate due to infection is highest among immunocompromised patients. The most common pathogens remain Candida and Aspergillus. An increase in the incidence of infections due to resistant and new pathogens has been observed. The diagnostic recommendations for invasive mycoses include clinical examination, imaging methods and laboratory tests. Therapeutic options in immunocompromised patients include prophylaxis, pre-emptive and empiric treatment and therapy of established fungal infection. This approach should based on patient risk-group stratification, diagnostic techniques to identify very early stage of infection and toxicity of antifungal drugs. The “gold standard” in treatment of invasive fungal infections was amphotericin B. New antifungal agents with similar or higher efficacy and lower toxicity have been introduced. These are lipid formulations of amphotericin B, new azoles, and echinocandines.