AN AUTOPSY STUDY OF SYSTEMIC FUNGAL-INFECTIONS IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES

The aim of this study was to determine the incidence of fungal infecti ons detected on autopsy in a group of 40 patients with hematologic mal ignancies treated with intensive chemotherapy or bone marrow transplan tation, and to evaluate the risk factors for fungal infections. A cont rol group included 38 patients with nonhematologic diseases and withou t granulocytopenia but with at least one of the known risk factors for fungal infections. Standard histopathological and microbiological met hods were used. A higher incidence of invasive fungal infections was f ound in patients with hematologic malignancies as compared to the cont rol group (p < 0.01). The predominant causes of fungal infections were Candida albicans and Aspergillus spp. The incidence of fungal infecti ons caused by Aspergillus was higher (p < 0.05) in patients with hemat ologic malignancies than in the control group. The independent risk fa ctors for fungal infections were fungal colonization, number of antibi otics and duration of antibiotic therapy, duration of fever and skin r ash. A higher proportion of fungal infections was diagnosed on autopsy than during the patients' life (p < 0.01).