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Systemic candidiasis in cancer patients.

A W Maksymiuk, S Thongprasert, R Hopfer

    The American Journal of Medicine
    |October 30, 1984
    PubMed
    Summary

    Fungal infections, primarily Candida, are common in cancer patients, especially those with leukemia. Deep organ infections have a poor prognosis, highlighting the need for early diagnosis and effective treatment strategies.

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    Area of Science:

    • Infectious Diseases
    • Oncology
    • Mycology

    Background:

    • Fungal infections pose a significant threat to immunocompromised patients with malignant diseases.
    • Candida species and Torulopsis glabrata are common culprits in hospital-acquired fungal infections.

    Purpose of the Study:

    • To review the incidence, predisposing factors, and outcomes of fungal infections in cancer patients.
    • To analyze the diagnostic challenges and mortality associated with candidiasis in this population.

    Main Methods:

    • Retrospective analysis of 235 fungal infections over a four-year period.
    • Focus on 188 infections caused by Candida species and Torulopsis glabrata.
    • Review of patient data including predisposing factors, clinical presentation, diagnostic methods, and treatment outcomes.

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    Main Results:

    • Fungal infections occurred in 11.9 per 100 registrations in acute leukemia patients, and 0.8 per 100 in all cancer patients.
    • Over 50% of cases had three or more predisposing factors, most commonly myelosuppression, chemotherapy, and antibiotic therapy.
    • Blood cultures were positive in only 35% of disseminated candidiasis cases.
    • Recovery rates were significantly lower for proved deep organ infections (4.5%) compared to candidemia without organ involvement (53%).
    • Respiratory failure was the leading cause of death (62%).

    Conclusions:

    • Fungal infections, particularly candidiasis, are a serious complication in cancer patients, with high mortality, especially in cases of deep organ involvement.
    • Early diagnosis is challenging due to non-specific clinical features and low sensitivity of diagnostic tests.
    • Effective antifungal strategies and improved diagnostic approaches are crucial for better patient outcomes.