Invasive fungal infection - Laboratory diagnosis and antifungal treatment
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
39
Journal Issue
3
Pages
178-188
Date Issued
2006
Author(s)
Abstract
Invasive fungal infections (IFIs) have become increasingly prevalent in the recent decade along with the increasing populations of immunocompromised patients and widespread use of the broad-spectrum antibiotics. The morbidity and the mortality of IFIs remain high while the diagnosis and treatment of IFIs are highly challenging. Recent advances in diagnostic methods and antifungal agents provide the potential to improve the outcomes of these infections. Conventional diagnostic methods including microbiological cultures and histopathological diagnosis have the disadvantages of either insensitivity or requiring invasive procedures. The innovative techniques of detecting circulating fungal antigens and detecting fungal genomic DNA represent improvements in the diagnosis of invasive aspergillosis. Several antifungal agents have been developed in recent years, such as lipid formulations of amphotericin B, newer azoles, and echinocandins. These agents have either lower toxicities or greater activities against certain fungi compared with older treatments. With the availability of diverse antifungal agents, their use in combination has the potential to produce additive or synergistic effects, leading to better treatment outcomes. Large-scale randomized clinical trials are needed to confirm the efficacy of combination strategies. ? 2006 Journal of Microbiology, Immunology and Infection.
SDGs
Other Subjects
amphotericin B; amphotericin B cholesterol sulfate; amphotericin B deoxycholate; amphotericin B lipid complex; anidulafungin; antifungal agent; caspofungin; echinocandin; fluconazole; flucytosine; fungus antigen; galactomannan; genomic DNA; glucan; itraconazole; micafungin; posaconazole; voriconazole; abnormally high substrate concentration in blood; aspergillosis; candidiasis; chill; clinical trial; diagnostic procedure; drug antagonism; drug bioavailability; drug dosage form; drug formulation; drug mechanism; drug potentiation; electrolyte disturbance; enzyme blood level; fever; histopathology; human; laboratory diagnosis; liver toxicity; morbidity; mortality; mycosis; nausea and vomiting; nephrotoxicity; nonhuman; rash; review; treatment outcome; visual disorder; Antifungal Agents; Fungi; Humans; Mycoses
Type
review