TREATMENT OF DEEP MYCOTIC INFECTIONS IN IMMUNO-COMPROMISED
Objective :A review of deep seated mycotic infections in immuno-compromised patients in China, the Incidence, Diagnosis and Treatments with Fluconazole & Itraconazole.Material and Methodes : Patients collected from inpatients of hematology, oncology,ICU,transplant dept. respiratology,ENT. Blood cultures by use Back/Alert system;sputum.BAL,urine stool and other excretion culture by use of Sabouraud medium. Identification byuse VITEK AMS System. Results:Blood cultures:57/1900(3%)specimens positive for fungus.These include 33/57(82%) specimens collected from hematological and oncological patients.93% were Candida sp.(C.albicanus,C.tropicalis, C. parapuliosis, C.globrata). 1. Leukemias: 11/44 cases with fungus infections , these include AGL 6/32.ALL 5/12. 2.ICU: 15/142 cases with fungus infections (all Candida sp.). 2. ICU: 15/142 cases with fungus infections,these include Candida 94.1% (C.albicanus 40%,C.tropicalis 60%) Aspergillus 5.9%. 3. Respiratorydeep mycotic infections:Total 127 cases,42% cases have predisposed diseases;hematological diseases 12%, immunodeficiency 21%, urinary disorders 8%. Candida sp. 84%, Aspergillus10%,mucor 6%. 4.Gastroesophegeal reflux diseases(GRED)16/16(100%) with C.albicanus.5.Intravenous catherterization:13/100 with Candida spp. infections. 6. Kidney transplatation:7/51 complicated with fungus infections, 5/13 C. albicanus, 2/7 C. tropicalis. Diagnosis :Mostly by culture,some by the help of ELISA,use antigen(1-3)B-D-glucan. Biopsy specimensuse HE,PAS and immunostaining (ISH) methods. Treatment and conclusions: Fluconazole was first choice for Candida spp. infections and Cryptococcus neoformans. Itraconazole for in-vasive Aspergillus sp.infections, AMB i.v.or intrathecal injection for severe mycotic infections.
Full conference title:
22nd International Congress of Chemotherapy (ICC)