|
|||||
|
|
Identification and management of invasive mycoses in internal medicine: a road-map for physicians |
|
| Authors: | Marco Falcone Ercole Concia Ido Iori Giuliana Lo Cascio Antonino Mazzone Federico Pea Francesco Violi Mario Venditti |
| Affiliation: | 1. Department of Public Health and Infectious Diseases, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy 2. Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico G B Rossi, Verona, Italy 3. Stroke Unit, Medicina Interna, Centro Emostasi E Trombosi, Azienda Ospedaliera ASMN di Reggio Emilia, Reggio Emilia, Italy 4. Department of Pathology and Diagnostics, Servizio di Microbiologia E Virologia, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37100, Verona, Italy 5. Internal Medicine Department, Hospital of Legnano, Legnano, Italy 6. Institute of Clinical Pharmacology, Azienda Ospedaliero-Universitaria Santa Maria Della Misericordia, Udine, Italy 7. I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy |
| Abstract: | Invasive mycoses are a rising problem, not only in traditional categories of patients like hematologic or neutropenic ones, but also in elderly non-neutropenic patients admitted to internal medicine wards. Patients being admitted to medical wards are usually older, have multiple comorbidities, e.g., liver cirrhosis or chronic obstructive respiratory disease, may be malnourished or receive peripheral or total parenteral nutrition, and frequently are undergoing chronic corticosteroid therapy, chemotherapy for cancer or monoclonal antibodies for autoimmune diseases. Such risk factors may be contemporarily present in a single patient increasing the risk for the development of invasive mycoses. Diagnosis of candidemia and invasive aspergillosis is particularly difficult in patients hospitalized on medical wards, since symptoms and signs have low specificity, and most diagnostic tests have been only validated in neutropenic hematologic patients, but not in those without neutropenia. Both candidemia and invasive aspergillosis carry significant morbidity and mortality. The aim of this paper is to provide a simple guide to physicians for a prompt identification and treatment of patients with possible or suspected invasive mycoses. |
| Keywords: | |
| 本文献已被 SpringerLink 等数据库收录！ | |