Diagnostic challenges and recent advances in the early management of invasive fungal infections
- 11 March 2010
- journal article
- review article
- Published by Wiley in European Journal of Haematology
- Vol. 84 (4), 281-290
- https://doi.org/10.1111/j.1600-0609.2009.01391.x
Abstract
During the past 20 yr, the population of immunocompromized patients at risk of developing invasive fungal infections (IFIs) has increased, and there has been a shift in fungal epidemiology, with more infections caused by non-Aspergillus molds and yeasts, which are often resistant to one or more antifungal drugs. Traditional diagnostic methods, such as culture and the histopathology of infected tissue, often fail to detect IFIs until the later stages. Furthermore, invasive diagnostic methods to obtain tissue may be contraindicated in severely ill patients; even when tissue is available, the morphology of several filamentous fungi is identical, or the cultures may fail to grow the pathogen. Recently developed non-invasive diagnostic techniques, such as tests for serum markers and polymerase chain reaction assays, may allow for earlier and more accurate diagnoses - crucial in the effort to reduce morbidity and the risk of mortality. This article reviews current approaches to diagnosis and treatment, focusing on how an early and accurate diagnosis can guide treatment and improve outcomes. Strategies for improving the management of IFIs also are discussed.This publication has 89 references indexed in Scilit:
- The economic impact of aspergillosis: analysis of hospital expenditures across patient subgroupsInternational Journal of Infectious Diseases, 2009
- Contemporary Tools for the Diagnosis and Management of Invasive MycosesClinical Infectious Diseases, 2006
- The Epidemiology and Attributable Outcomes of Candidemia in Adults and Children Hospitalized in the United States: A Propensity AnalysisClinical Infectious Diseases, 2005
- Nosocomial Bloodstream Infections in US Hospitals: Analysis of 24,179 Cases from a Prospective Nationwide Surveillance StudyClinical Infectious Diseases, 2004
- Epidemiology and Outcome of Mould Infections in Hematopoietic Stem Cell Transplant RecipientsClinical Infectious Diseases, 2002
- Diagnosis of fungal infections: current statusJournal of Antimicrobial Chemotherapy, 2002
- Trends in Mortality Due to Invasive Mycotic Diseases in the United States, 1980–1997Clinical Infectious Diseases, 2001
- Invasive Mold Infections in Allogeneic Bone Marrow Transplant RecipientsClinical Infectious Diseases, 2001
- Aspergillosis Case-Fatality Rate: Systematic Review of the LiteratureClinical Infectious Diseases, 2001
- Burden of Aspergillosis?Related Hospitalizations in the United StatesClinical Infectious Diseases, 2000