Systemic fungal infections cause almost 25% of the infection-related deaths
in leukaemic patients. Particularly those with prolonged neutropenia are a
t risk but mycoses also feature in critically ill intensive care patients a
nd in individuals who are treated for solid tumours and AIDS, or who receiv
ed an organ transplant. The spread of AIDS and the more aggressive cytotoxi
c chemotherapy in combination with an improved management of haemorrhages a
nd bacterial infections in leukaemic and other cancer patients facilitated
the occurrence of these invasive fungal infections. These life-threatening
complications remain both difficult to diagnose and to treat and therefore
carry a poor prognosis. For many years, the only realistic option to treat
systemic infections was amphotericin B, whose administration was known to b
e associated with numerous adverse effects. Now less toxic formulations of
amphotericin have become available for clinical use, as well as several new
triazoles that appear to provide an effective and less toxic alternative f
or the treatment of certain fungal infections.