الفهرس 
Introduction
IntroductionOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
Invasive fungal infections are important causes of morbidity and mortality in
patients with hematological malignancies and those who are undergoing
hemopiotic stem cell transplantation (HSCT). The most significant risk factors in
these settings are prolonged ad profound neutropenia and therapy with high doses
of corticosteroids. The overall frequency of invasive fungal infections in patients
with acute leukemia and following allogenic HSCT (the patient population at
highest risk) is between 10% and 25%; the overall case fatality rate exceeds 50% and
is close to 100% in disseminated infections or persistent neutropenia. While
Aspergillus and Candida species traditionally accounts for the majority documented
infections, recent epidemiologic trends indicate a shift towards infections by
Aspergillus species, non-albicans Candida species, and previously uncommon fungi
that often have little susceptibility to current antifungal agents (Andreas et al., 2002).
Increased awareness among physicians, improved blood culture technique, and
the advent of high-resolution imaging techniques have had considerable impact on
improving the clinical diagnosis of invasive fungal infections, and major progress
has been made in harmonizing disease definitions, in defining paradigms for
antifungal intervention, and designing and implementing clinical trials. Despite
these advances, however, invasive fungal infections remain difficult to diagnose and
to manage and there is a contributing and urgent need for improved diagnosis,
treatment and prevention (Andreas et al., 2002).
Aetiology:
Aspergillus and Candida species account for most fungal infections in cancer
patients. However, life-threatening infections caused by emerging pathogens such
as Trichosporon beigelii, Fusarium species, Pseudallescheria boydii, Zygomycetes
(agents of mucormycosis), and Malassezia furfur are increasing in frequency The major risk factors for infections with these organisms are prolonged
neutropenia and impaired cell-mediated immunity due either to the cancer or to the
use of medications such as cytotoxic drugs or corticosteroids.