INVASIVE MOLD INFECTIONS IN CANCER-PATIENTS - 5 YEARS EXPERIENCE WITHASPERGILLUS, MUCOR, FUSARIUM AND ACREMONIUM INFECTIONS

Twenty systemic mold infections due to hyphic fungi (molds) arising wi thin the last 5 years in a 60-bed cancer department are analyzed. The most frequent risk factors were plants in ward (75%), prior therapy wi th broad spectrum antibiotics (70%), catheter insertion (70%), acute l eukemia (65%) and neutropenia (60%). Before death, a definitive diagno sis was made in 40%, and a presumptive diagnosis in 60% of patients; p ost mortem the presumptive antemortem diagnosis was confirmed in all c ases (100% of patients). Aspergillosis was the most common invasive fu ngal disease (55%), followed by mucormycosis (15%), fusariosis (15%), and acremoniosis (10%). Of 20 patients, 8 (40%) were cured or improved after antifungal therapy with amphotericin B, ambisome and/or itracon azole; 8/20 (40%) died of fungal infection and 4/20 (20%) of underlyin g disease with fungal infection. Even though the diagnosis was made an d antifungal therapy started before death in 15/20 (75%), invasive mol d infection had a 60% overall mortality in patients with malignant dis ease.