Funcal Infections in Cancer Patients: Problems in Diagnosis and Therapy, and New Approaches

Fungal infections are an important cause of mortality and morbidity in patients, especially those with immunosupression. An intensive immunosupressive therapy, prolonged neutropenia, impairment in cellular immunity, fungal colonization after broad-spectrum antibiotics, and extensive mucositis caused by cytotoxic chemotherapy are the major risk factors for invasive fungal infections. The spectrum of fungal infections have also changed in these patients. While Candida and Aspergillus species have long been the only causative pathogens, currently any fungus may cause invasive disease. Difficulty in diagnosis is an impotant problem challenging the physicians in this regard. There are no clinical sings and symptoms specific to invasive fungal infections, radiological imaging studies and microbiologic methods do not always establish the diagnosis. On the other hand, the available antifungal agents are limited and far from being ideal; thus the response rates are still lagging behind those of bacterial infections. Nevertheless, several advences have recently been made for diagnosis and therapy, and promising resulty have been obtained