Ahn Hyojin, Lee Raeseok, Cho Sung-Yeon, Lee Dong-Gun
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Blood Res. 2022 Apr 30;57(S1):101-111. doi: 10.5045/br.2022.2022036.
Invasive fungal infections (IFIs) are common causes of mortality and morbidity in patients with hematologic diseases. Delayed initiation of antifungal treatment is related to mortality. sp. is the leading cause of IFI followed by sp. Diagnosis is often challenging owing to variable conditions related to underlying diseases. Clinical suspect and prompt management is important. Imaging, biopsy, and non-culture-based tests must be considered together. New diagnostic procedures have been improved, including antigen-based assays and molecular detection of fungal DNA. Among hematologic diseases, patients with acute myeloid leukemia, myelodysplastic syndrome, recipients of hematopoietic stem cell transplantation are at high risk for IFIs. Antifungal prophylaxis is recommended for these high-risk patients. There are continuous attempts to achieve ideal management of IFIs. Scoring system for quality control has been developed with important recommendations of current guidelines. Higher adherence to guidelines is related to decreased mortality in IFIs.
侵袭性真菌感染(IFI)是血液系统疾病患者死亡和发病的常见原因。抗真菌治疗的延迟启动与死亡率相关。 菌属是IFI的主要病因,其次是 菌属。由于与基础疾病相关的情况各异,诊断往往具有挑战性。临床怀疑和及时处理很重要。必须综合考虑影像学、活检和非培养检测。新的诊断程序已经得到改进,包括基于抗原的检测和真菌DNA的分子检测。在血液系统疾病中,急性髓系白血病、骨髓增生异常综合征患者以及造血干细胞移植受者发生IFI的风险很高。建议对这些高危患者进行抗真菌预防。人们一直在不断努力实现对IFI的理想管理。已经制定了质量控制评分系统,并参考了当前指南的重要建议。更高程度地遵循指南与降低IFI的死亡率相关。