Fungal infections in immunocompromised patients

Daunorabicin (DaunoXome, Gilead Sciences, Inc.) Doxorubicin (Doxil/Caelyx, Ortho Biotech ProductsLP/Sequus Pharmaceuticals) Amphotericin B (Ambisome/Abelcet, Fujisawa Healthcare, Wyeth Pharmaceuticals) Doxorubicin (Myocet/Evacet, Sopherion/ Liposome Company) Hepatitis A virus envelope proteins (Epaxal, Berna Biotech) Influenza virus (Inflexal V, Berna Biotech) Verteporfin (Visudyne, Novartis Ophthalmics) Kaposi s sarcoma Kaposi s sarcoma Fungal infections in immunocompromised patients Metastatic breast cancer Hepatitis A Influenza Age-related macular degeneration... 

Ringden 0, Meunier F, Tollemar J, Ricci P, Tura S, Kuse E. Efficacy of amphotericin B encapsulated in liposomes (AmBisome) in the treatment of invasive fungal infections in immunocompromised patients. J Antimicrob Chemother 1991 28 73-82. 

Caruiida albicans Azole-resistant strains are emerging invasive candidiasis has recently increased 10-fold to become the fourth leading fungal infection in immunocompromised patients... 

M. H. Miceli and P. Chandrasekar, Safety and efficacy of liposomal amphotericin B for the empirical therapy of invasive fungal infections in immunocompromised patients. Infect. Drug Resist., 2012, 5, 9 16. 

B. Amphotericin B remains the drug of choice in the treatment of disseminated or invasive fungal infections in immunocompromised hosts bone marrow transplant recipients are the most heavily immunocompromised patients encountered in the hospital setting. 5-Flucytosine has no significant activity against Aspergillus spp., and it has bone marrow toxicity as a common adverse effect it should... 

Sordarin derivatives, (n), prepared by Balkovec (2) were effective in treating fungal infections caused by C. albicans and used in treating infections in immunocompromised patients. 

Amphotericin B (AmB) is a broad-spectrum antifungal agent that is the antibiotic of choice for disseminated fungal infections, particularly in immunocompromised patients. AmB is also used for the treatment of Leishmaniasis as a second-line treatment. However, its toxicity toward mammalian cells is often dose limiting, whatever its indication. 

Over the last fifty years, as chemotherapeutics for the treatment of cancer, bacterial infections, and to prevent transplant rejections have improved, there has been a concomitant increase in the number of patients suffering from fungal infections. In the past, most fungal infections were superficial, affecting only the skin, hair, or nails. However, as medical science has progressed in other disease areas, many more patients are immunocompromised, which has resulted in a greater incidence of systemic fungal infections. 

Recognition of the role of the GI tract in invasive Candida infections has led to efforts to decrease infections by prophylactic administration of topical or systemically absorbed antifungal agents in immunocompromised patients. The use of systemically absorbable agents such as azole antifungal agents appears to decrease the risk of invasive fungal infections. ... 

Fungal infections of the liver are very rare in normal patients. They are more typically seen in immunocompromised patients secondary to chemotherapy or AIDS-HIV. 

Since oropharyngeal and esophageal candidiasis are signs of immunocompromise, the immune status of the patient should be considered in the therapeutic care plan. For HIV-infected patients, this should also include an evaluation of the patient s antiretroviral therapy since fungal infections may represent deterioration in immune status. 

Amphotericin B remains the drug of choice in the treatment of invasive aspergillosis, locally invasive mucormycosis, and many disseminated fungal infections occurring in immunocompromised hosts (the patient population most at risk for serious fungal infections). For example, the febrile neutropenic oncology patient with persistent fever despite empirical antibacterial therapy is best treated with amphotericin B for possible Candida spp. sepsis. 

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