Related Experiment Video

Updated: Aug 5, 2026

An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
07:42

An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract

Published on: July 1, 2020

Management of invasive fungal infections in the intensive care unit

Dara Chean1, Alice Friol2, Elie Azoulay2

  • 1Service de Réanimation Polyvalente, Centre Hospitalier de Laval, Laval, France.

Expert Review of Anti-Infective Therapy
|July 27, 2026
PubMed
Abstract

Insights

Invasive fungal infections (IFI) are increasing in ICUs. Early suspicion, targeted diagnostics, and prompt antifungal therapy are crucial for managing critically ill patients with IFI.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Mycology

Background:

  • Invasive fungal infections (IFI) are increasingly prevalent in intensive care units (ICUs).
  • These infections, including aspergillosis, candidiasis, and mucormycosis, carry high mortality rates.
  • Diagnosis is challenging due to difficulties in obtaining histopathological confirmation.

Purpose of the Study:

  • To review current evidence on the epidemiology, risk factors, and management of IFI in critically ill patients.
  • To discuss adaptations of diagnostic criteria and the role of non-culture-based tools in the ICU.
  • To outline ICU-specific diagnostic and therapeutic strategies for invasive fungal infections.

Main Methods:

  • This narrative review synthesizes existing literature on IFI in the ICU.
  • It examines epidemiological data, risk factors, and diagnostic approaches.
  • Management strategies, including antifungal therapy and diagnostic testing, are discussed.

Main Results:

  • IFI management in ICUs necessitates a probabilistic approach integrating host factors, clinical signs, and mycological data.
  • Non-culture-based diagnostic tools show promise but require further validation in ICU cohorts.
  • Effective management hinges on early clinical suspicion and timely intervention.

Conclusions:

  • Optimal management of IFI in critically ill patients requires an individualized strategy.
  • This includes robust clinical risk stratification, judicious use of diagnostic tests, and prompt antifungal treatment.
  • Further research into risk stratification and molecular diagnostics is essential to improve patient outcomes.
Keywords:
Invasive fungal infectionaspergillosiscandidiasisimmunocompromised patientsintensive care unitmucormycosis

Related Concept Videos

Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Cystic Fibrosis: Management01:24

Cystic Fibrosis: Management

Cystic fibrosis (CF) is an autosomal recessive disorder that predominantly affects individuals of Northern European descent, occurring at a rate of 1 in 3500. It is caused by a genetic mutation in a gene on chromosome 7, most commonly the ΔF508 mutation, that codes for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. This results in thicker mucus secretions and obstruction pathologies in multiple organs, including the lungs and sinuses.
Sinus disease and chronic sinusitis...