Candidemia in patients with acute leukemia

To present the clinical course and laboratory results of leukemic patients with candidemia and to comment on the incidence and clinical findings of mycoses in this particular patient population.

From 2002 to 2005 in the Department of Hematology of our institution 53 leukemic patients with clinical signs of infection and severe neutropenia after intensive chemotherapy presented 127 febrile episodes during which blood cultures were taken, both from central venous catheters and from peripheral veins with a sterile method as described elsewhere.

4/53 (7.5%) of neutropenic patients presented disseminated candidiasis with positive blood cultures with different species of Candida (C) according to the EORTC criteria. Two patients had strains susceptible to all or most antifungal agents, 1 had dose-dependent sensitivity and 1 had C. krusei resistant to all agents. Two patients died probably because of disseminated candidiasis, 1 survived and 1 died of unrelated cause.

Fungal infections are not uncommon in patients with hematological malignancies, but they are rarely microbiologically documented. A fast and reliable means of diagnosis of invasive fungal infections is urgently needed.