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Fungal infections in surgical patients
1Klinik für Chirurgie, Universität Lübeck, Germany.
Abstract:
Deep fungal infection was diagnosed in 42 patients (a rate of four per 1000) treated during a one-year period between 1988 and 1989 at the Surgical Clinic in Würzburg. Most occurred in association with damage to intra-abdominal hollow organs. Diagnosis of deep fungal infections is difficult and only histological identification provides definite proof. However, often the decision to treat has to be made on the basis of the clinical picture and the physician's subjective assessment. Combination treatment with amphotericin B and 5-fluorocytosine is still the current recommendation but the introduction of the azole antifungal agents appears likely to bring about a change. A trial of fluconazole showed it to have clear advantages over combination treatment, being effective, well tolerated and easily administered.
Insights
Deep fungal infections, often linked to abdominal organ damage, are challenging to diagnose. Fluconazole offers a more effective, well-tolerated, and simpler treatment option compared to older combination therapies.
Area of Science:
- Medicine
- Infectious Diseases
- Surgery
Background:
- Deep fungal infections pose diagnostic challenges, often requiring histological confirmation.
- Most cases occurred in patients with intra-abdominal hollow organ damage.
- Clinical assessment and physician judgment frequently guide treatment decisions.
Purpose of the Study:
- To evaluate the efficacy and tolerability of fluconazole in treating deep fungal infections.
- To compare fluconazole treatment with traditional combination therapy.
Main Methods:
- Retrospective analysis of 42 patients diagnosed with deep fungal infections between 1988-1989.
- Clinical observation and histological identification were used for diagnosis.
- Treatment outcomes were compared between fluconazole and combination therapy (amphotericin B and 5-fluorocytosine).
Main Results:
- Fluconazole demonstrated clear advantages over the combination treatment.
- The study highlighted fluconazole's effectiveness, good tolerability, and ease of administration.
- Deep fungal infections were diagnosed at a rate of four per 1000 patients.
Conclusions:
- Fluconazole represents a significant advancement in treating deep fungal infections.
- The introduction of azole antifungals like fluconazole is likely to change current treatment recommendations.
- Further research into azole antifungal agents is warranted for improved patient outcomes.