[Clinical course and risk factors in patients with generalized mycoses]

A retrospective analysis of the clinical course of disseminated fungal infections in 32 patients revealed 25 cases of candidiasis, 5 patients with aspergillosis, and 2 with mixed fungal infections. All patients had undergone cytostatic therapy for malignant hematological diseases as the predisposing risk factor for fungal infection. 30 patients had severe granulocytopenia (less than 500/cmm). In addition, 30 patients had received broad spectrum antibiotics and 16 had been treated with corticosteroids. 17 of 32 patients were treated systemically with antimycotic drugs for proven fungal infection. No antimycotic agents were given to 15 patients because fungal infections were diagnosed only on post mortem examination. 19 patients succumbed to overwhelming disease, including 5 in spite of antimycotic therapy. Patients in whom systemic candidiasis was detected after recovery of granulocytopoeisis had a better prognosis than patients who developed systemic fungal infections during the period of ongoing severe granulocytopenia.