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Fungal infections in the immunocompromised host.
1Evans Memorial Department of Clinical Research, Boston University School of Medicine, Massachusetts.
Diagnostic Microbiology and Infectious Disease
|July 1, 1989
Summary
Immunocompromised patients face increased fungal infections like candidiasis and cryptococcosis. New oral azoles offer promising, practical treatment for life-threatening mycoses.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Immunology
Background:
- Rising incidence of invasive fungal infections in immunocompromised populations.
- Diverse fungal pathogens associated with specific immune dysfunctions (e.g., Candida, Aspergillus in neutropenia; Cryptococcus, Histoplasma in AIDS).
- Predisposing factors include neutropenia, cell-mediated immune dysfunction, antibiotic use, and immunosuppressive therapies.
Purpose of the Study:
- To review the spectrum of fungal infections in immunocompromised patients.
- To highlight diagnostic challenges and therapeutic limitations.
- To discuss the potential impact of novel antifungal agents.
Main Methods:
- Review of current literature on fungal infections in immunocompromised hosts.
- Analysis of etiologic agents based on immune status.
- Discussion of diagnostic modalities and treatment strategies.
Main Results:
- Specific fungi are linked to distinct immune deficiencies, increasing morbidity and mortality.
- Diagnosis is often delayed by invasive procedures and slow culture results.
- New oral azoles show potential for treating serious fungal infections, including aspergillosis and cryptococcosis.
Conclusions:
- Invasive fungal diseases pose significant threats to immunocompromised patients.
- Timely diagnosis and effective treatment are crucial.
- Advancements in antifungal therapeutics, particularly oral azoles, offer hope for improved patient outcomes.