Invasive fungal infection in immunosuppressed patients treated in a tertiary hospital
Infección fúngica invasiva en pacientes inmunosuprimidos atendidos en un hospital de tercer nivel
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Background: invasive fungal infections (IFI) are a major cause of mortality and morbidity worldwide. The increased incidence of these fungal infections are associated with an increase in immunosuppressive conditions.
Objective: to describe demographic and clinical characteristics of immunosuppressed patients treated with antifungals for suspected invasive fungal infection (IFI) in a tertiary hospital.
Materials and methods: in this descriptive cross-sectional study, immunosuppressed patients receiving antifungal treatment during 2012 and 2013, with suspected IFI (aspergillosis, cryptococcosis, mucormicosis and histoplasmosis) were included.
Results: 81 patients, predominantly men (66.5%), with a mean age of 43.8 years were analyzed. The most common underlying conditions were lymphoproliferative disorders followed by HIV infection. Angioinvasive aspergillosis (52%) and cryptococcosis (28%) were most frequently suspected. 43% and 85% of patients had abnormal findings on chest radiograph and CT, respectively. 22% of the patients died and 17% required monitoring in the ICU and hemodynamic support. Conclusion: This highlights the importance of a high index of suspicion and early diagnosis of IFI, following an algorithm that enables the timely initiation of antifungal treatment to reduce fatal outcomes. It also identifies the obstacles of getting microbiological confirmation of these pathogens; the difficulties being similar in our institution to those reported elsewhere.
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