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[Fungal infections after bone marrow transplantation--an autopsy study]
U Schmidt1, B Pfaffenbach, K Quabeck
1Institut für Pathologie, Universitätsklinik Essen.
Abstract:
This report analyses the frequency, the pattern and the severity of mycotic infection in a necropsy series of 103 bone marrow transplantations. Fungal infection was documented in 33 (32%) of all death cases. The risk of mycotic infection was increased in patients with graft failure and after retransplantation. At post mortem examination, most cases showed invasive fungal infections. The most frequent organ manifestations were the lungs, the gastrointestinal tract, the kidneys, the heart and the brain. In 19 of 33 patients (57%), mycotic disease was the primary cause of death. Fungal infections still cause major problems in clinical diagnosis, because there remain cases that will be documented only if post mortem examination is performed.
Insights
Fungal infections are a significant threat after bone marrow transplantation, causing death in 32% of cases. Early diagnosis and intervention are crucial for improving patient outcomes in transplant recipients.
Area of Science:
- Mycology
- Transplantation Immunology
- Pathology
Context:
- Bone marrow transplantation (BMT) is a critical treatment for hematologic malignancies and other diseases.
- Patients undergoing BMT are immunocompromised, increasing their susceptibility to opportunistic infections.
- Mycotic (fungal) infections pose a substantial threat to BMT recipients, impacting survival rates.
Purpose:
- To analyze the frequency, pattern, and severity of mycotic infections in a necropsy series of 103 bone marrow transplantations.
- To identify risk factors associated with increased mycotic infection in BMT patients.
- To determine the contribution of fungal infections to mortality in this population.
Summary:
- Fungal infection was documented in 33% of BMT death cases.
- Increased risk of fungal infection was observed in patients with graft failure and after retransplantation.
- Invasive fungal infections were prevalent at post-mortem, affecting lungs, gastrointestinal tract, kidneys, heart, and brain.
- Mycotic disease was the primary cause of death in 57% of infected patients.
- Post-mortem examination is vital for documenting fungal infections, as clinical diagnosis can be challenging.
Impact:
- Highlights the significant mortality associated with fungal infections post-BMT.
- Underscores the importance of post-mortem examinations for accurate diagnosis and understanding of fungal disease burden.
- Informs clinical practice regarding surveillance and management of fungal infections in immunocompromised transplant patients.