Deep Fungal Infection in Patients with Hematopoietic Malignancies: A Clinical Analysis / 中华医院感染学杂志

ABSTRACT

OBJECTIVE To investigate the manifestation,fungal spectrum,diagnosis,antifungal therapy and(outcome) of deep fungal infection(DFI) in patients with hematopoietic malignancies.METHODS Fifty-two(patients) of SFI admitted in Shandong Provincial Hospital during Oct 1998 to Sept 2004 were enrolled in this(investigation,) including 34 males and 18 females with mean age of 54 years old.Clinical data,such as manifestation,fungal(spectrum,) treatment and outcome,were observed prospectively and retrospectively.RESULTS Lower respiratory tract,gastrointestinal tract,urinary tract and blood were the main DFI infection sites by order of prevalence.The clinical manifestation was various among cases.Pathogen detection determined the subtypes of fungi were Candida albicans(57.14%),C.tropicalis(21.43%),yeast(47.14%),C.parapsilosis(7.14%),and Aspergillus((5.36%).) Nystatin,fluconazole,flucytosine,and(amphotericin) B were used alone or in(combination) to treat DFI.The rates of curing,improvement and death were 44.23%,23.08% and 32.69%,(respectively).(Among) 52 cases,25(48.08%) were occurred during Oct 2002 to Sept 2004,compared with 27((51.92%)) during Oct 1998 to Sept 2002,suggested the elevated incidence of DFI.CONCLUSIONS The incidence of DFI in patients with hematopoietic malignancies is increasing these years.The clinical manifestation of DFI may be nonspecific.It is critical to pay more attention to the fungal infection among the high-risk patients,therefore fungus detection from various(samples) should be recommended for the sake of early diagnosis of DFI. Though(C.albicans) remains the top in pathogen spectrum analysis,infection of other fungi tends to increase.The mortality of DFI is still very high thus more investigations about early diagnosis and treatment of DFI should be conducted.