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Invasive fungal infections in patients with hematologic malignancies in a tertiary care cancer center: An autopsy study over a 15-year period (1989-2003)
Georgios Chamilos; Mario Luna; Russell E. Lewis; Gerald P. Bodey; Roy Chemaly; Jeffrey J. Tarrand; Amar Safdar; Issam I. Raad; Dimitrios P. Kontoyiannis (Profiled Authors: Roy F Chemaly; Dimitrios P Kontoyiannis; Issam I Raad; Jeffrey J Tarrand)
We evaluated autopsy-proven invasive fungal infections (IFI) in patients with hematologic malignancies over three periods (1989-1993, 1994-1998, and 1999-2003). The autopsy rate declined significantly (67%-34%-26%, respectively p<0.0001). IFI were identified in 314 (31%) of 1017 autopsies. Most IFI (75%) were not diagnosed antemortem. The prevalence of invasive mold infections increased significantly (19%-24%-25% p=0.05) in parallel with the emergence of Zygomycetes (0.9%-4%-3%; p=0.03). The prevalence of all other IFI remained relatively constant. Among patients with invasive pulmonary aspergillosis, those with graft-versus-host disease had a histopathological pattern distinct from those with neutropenia. The complex and evolving epidemiology of IFI in severely immunocompromised patients is not well captured by current diagnostic methods. ©2006 Ferrata Storti Foundation.
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