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Published on: March 19, 2019
Emerging fungal infections in cancer patients
1University of Trnava, Department of Oncology, Slovak Republic.
Abstract:
The increasing number of reports in cancer patients that describe unusual or new fungal pathogens in severe systemic infections may be due, in part, to new treatment regimens but also to increased recognition of clinical disease by physicians and unusual organisms by microbiologists. Identification of these pathogens requires specialized expertise but the diagnosis may often be too late to permit effective therapeutic intervention. An unfortunate limitation of current antifungal agents is their limited efficacy in the heavily immunosuppressed, even when the drugs show good activity in vitro. Infections with Candida spp., and non-Candida yeasts and moulds are often disseminated and are frequently fatal in patients with severe immunosuppression. Therapeutic outcomes could be improved with more precise and rapid diagnostic procedures, standardized treatments for each pathogen and improved therapeutic agents. Liposomal amphotericin B formulations, new azole antifungals, more aggressive surgery and haemopoietic growth factors may improve the poor outcome that currently occurs with many of those infections.
Insights
New fungal pathogens are increasingly seen in cancer patients due to treatments and better recognition. Early diagnosis and new treatments are crucial for improving outcomes in severe immunosuppression.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Oncology
Background:
- Increasing reports of unusual fungal pathogens in cancer patients with severe systemic infections.
- Potential contributing factors include novel treatment regimens and enhanced clinical/microbiological recognition.
- Current diagnostic and therapeutic strategies face limitations, especially in heavily immunosuppressed individuals.
Purpose of the Study:
- To highlight the challenges in identifying and treating emerging fungal infections in cancer patients.
- To emphasize the need for improved diagnostic accuracy and timeliness.
- To discuss potential advancements in antifungal therapies and supportive care.
Main Methods:
- Review of current literature and clinical observations regarding fungal infections in cancer patients.
- Analysis of factors contributing to the rise of unusual fungal pathogens.
- Evaluation of the efficacy of existing and novel antifungal agents and treatment strategies.
Main Results:
- Identification of fungal pathogens often requires specialized expertise and can be delayed, hindering timely intervention.
- Current antifungal agents show limited efficacy in severely immunosuppressed patients.
- Disseminated infections with Candida spp., non-Candida yeasts, and moulds are frequently fatal in this population.
Conclusions:
- Improved diagnostic procedures, standardized pathogen-specific treatments, and novel therapeutic agents are essential for better outcomes.
- Emerging strategies like liposomal amphotericin B, new azoles, aggressive surgery, and growth factors show promise.
- Addressing the challenges of fungal infections in immunocompromised cancer patients requires a multi-faceted approach.
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