Immunosuppression fungal infections

The approach to antifungal therapy in patients with endemic fungal infections is determined by the severity of clinical presentation, the patient s underlying immunosuppression, and potential toxicities and drug interactions associated with antifungal treatment. 

Systemic fungal infections hypersensitivity to the drug IM use in ITP administration of live virus vaccines (eg, smallpox) in patients receiving immunosuppressive corticosteroid doses (see Warnings). 

Immunosuppression in general is associated with two other unwanted effects. Firstly, there is not only an increased risk of bacterial, viral and fungal infections but also various opportunistic infections occur. The second draw back is the risk for secondary tumors, especially lymphomas. 

In recent years, the incidence and severity of human fungal infections have increased dramatically. The use of powerful immunosuppressive agents for cancer chemotherapy and for organ transplant, combined with the AIDS epidemic, has led to this significant increase. However, in healthy individuals, a normally functioning immune system tends to ward off fungal infections. 

Often, fungal infections are relatively innocuous because they can be destroyed by the body s normal immune defense mechanisms. However, some infections require pharmacologic treatment, especially if the patient s endogenous defense mechanisms are compromised in some way. For instance, patients undergoing immunosuppressive drug treatment with... 

Candida albicans) after they received high doses of cytotoxic, immunosuppressive, or corticosteroid drugs. By monitoring the D/L arabinitol ratio, fungal infections can be diagnosed early enough to permit effective—in some cases, life-saving—treatment. The separation of trifluoroacetylated arabinitol is depicted in Fig. 14,... 

Infections, in particular bacterial and viral (cytomegalovirus, Herpes simplex virus, Epstein-Barr virus), and also protozoal and fungal infections, are major causes of morbidity and mortality in the post-transplantation period, whatever the immunosuppressive regimen used (50-52). Based on an analysis of medical and autopsy records, infections were found to be the cause of death in 70% of transplant patients, with bacteria (50%) or fungi (29%) the most common pathogens (53). 

In recent years, because of overzealous use of antibacteml antibiotics, the use of immunosuppressive agents, cytulo.i ins, irradiation, and. steroids, a new category of syslemi. mycoses has become prominent. These are the opportumsti fungal infections. There has been a precipitous rise in Ui incidence of these disea.ses. The patient, as a result of dm ... 

Purine analogues usually do not cause nausea and vomiting or hair loss, but they are associated with cumulative and prolonged myelosuppression and profound immunosuppression, which increases the risk of opportunistic infections such as fungal infections, Pneumocystis carinii pneumonia, and viral infections. 

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