Fungal infections in bone marrow transplant recipients

Area of Science:

• Hematology
• Infectious Diseases
• Transplantation Medicine

Background:

• Invasive fungal infections (IFIs) are a significant cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT).
• Candida and Aspergillus species are the most common fungal pathogens implicated in these infections.
• Risk factors include neutropenia, mucositis, graft-versus-host disease, and steroid use.

Purpose of the Study:

• To review the epidemiology, risk factors, clinical manifestations, diagnostics, prophylaxis, and treatment of IFIs in HSCT recipients.
• To highlight the challenges in diagnosing and managing IFIs due to non-specific symptoms and radiological findings.

Main Methods:

• Literature review of IFIs in HSCT patients.
• Analysis of risk factors, clinical presentations, diagnostic modalities, and therapeutic strategies.

Main Results:

• IFIs present with diverse clinical signs and nonspecific radiological findings, complicating diagnosis.
• Key risk factors identified include prolonged neutropenia, graft-versus-host disease, and immunosuppressive therapy.
• Diagnostic approaches encompass both culture-based and non-culture-based techniques.

Conclusions:

• Prophylaxis is recommended for high-risk HSCT patients, particularly those with severe graft-versus-host disease or prior fungal history.
• Treatment options involve azoles (e.g., voriconazole), amphotericin, and caspofungin.