Fungal complications of transplantation: diagnosis, treatment and prevention

Abstract

Invasive fungal infection remains a major problem in transplant recipients. The commonest causes of infection are Candida, and Aspergillus spp., although a growing number of other organisms (including species of Fusarium and Trichosporon) have been reported to cause infection in neutropenic bone marrow transplant recipients. The clinical manifestations of these infections are described and methods of diagnosis are discussed. As in other groups of immunocompromised patients, the diagnosis is often difficult to establish, but transplant recipients who are given empirical treatment with amphotericin B have increased rates of survival. The roles of lipid-associated forms of amphotericin B and of the triazole compounds, itraconazole and fluconazole, in the treatment and prevention of fungal infection are discussed.