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Emerging Invasive Fungal Infections: Clinical Features and Controversies in Diagnosis and Treatment Processes

Hongliang Zhang1, Aiqun Zhu1,2

  • 1Emergency Department, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, People's Republic of China.

Infection and Drug Resistance
|February 29, 2020
PubMed
Abstract

Insights

Diagnosing and treating invasive fungal infections (IFIs) is complex. Delayed diagnosis and treatment initiation significantly predict prolonged hospitalization, highlighting the need for improved IFI management strategies.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Invasive fungal infections (IFIs) present diagnostic and therapeutic challenges due to non-specific symptoms.
  • Emerging IFIs require further investigation into their clinical characteristics and outcomes.

Purpose of the Study:

  • To investigate the clinical features, diagnostic processes, and patient outcomes of emerging invasive fungal infections (IFIs).
  • To identify predictors of prolonged hospitalization in patients with IFIs.

Main Methods:

  • Retrospective review of adult patients diagnosed with IFIs at a Chinese university hospital.
  • Diagnosis adherence to EORTC/MSG 2008 criteria for proven, probable, and possible IFIs.
  • Analysis of diagnostic methods including sputum microscopy, culture, and 1,3-ß-D-glucan (BG) testing for pulmonary IFIs.

Main Results:

  • 145 IFI patients (pulmonary, intestinal, urinary) were analyzed; 55.2% were proven, 40.7% probable, and 4.1% possible.
  • For pulmonary IFIs, diagnostic test positivity rates were: sputum microscopy (54.0%), sputum culture (44.4%), and BG test (37.3%).
  • Independent predictors of prolonged hospitalization included delayed antifungal therapy initiation, liver cirrhosis, hematological tumors, coinfection, and immune diseases.

Conclusions:

  • Delayed diagnosis and treatment initiation are primary predictors of prolonged hospitalization in IFI patients.
  • Improving the diagnostic and therapeutic processes for IFIs is crucial for better patient prognosis.
  • Early intervention and management strategies are recommended to reduce hospitalization duration.
Keywords:
clinical featureshospitalizationinvasive fungal infectionsmicrobiological resultsrisk factors

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