Klinische Wochenschrift

, Volume 66, Issue 20, pp 1010–1014

Reduction of systemic fungal infections in patients with hematological malignancies, neutropenia, and prolonged fever by early amphotericin B therapy

  • M. B. Zimmermann-Hösli
  • R. A. Stahel
  • P. Vogt
  • O. Oelz
Originalien

DOI: 10.1007/BF01733443

Cite this article as:
Zimmermann-Hösli, M.B., Stahel, R.A., Vogt, P. et al. Klin Wochenschr (1988) 66: 1010. doi:10.1007/BF01733443

Summary

A rate on autopsy of up to 30% systemic fungal infections and difficulties in diagnosing systemic mycosis antemortem have led to the empiric use of amphotericin B in patients with hematological malignancies, prolonged fever, and neutropenia. Routine empiric antifungal treatment was initiated in our institution in 1982. Amphotericin B was given to granulocytopenic patients with hematological malignancies with (a) unremitting fever after 48–72 h of antibiotic treatment, (b) recurrent fever during antibiotic treatment, or (c) with newly detected pulmonary infiltrates, sinusitis, skin and retinal lesions suggestive of a fungal infection. With this approach the rate of systemic fungal infections decreased significantly from 10% (27 of 270 patients; 1973–1981) to 4% (6 of 153 patients; 1982–1986,P<0.02). The reduction of systemic fungal infections was most prominent in patients with acute myelogenous leukemia, where its proportion decreased from 16% (16 of 98 patients; 1973–1981) to 4% (2 of 50 patients; 1982–1986,P<0.023). Our data support the hypothesis that the incidence of systemic fungal infections in patients with hematological malignancies and especially in acute myelogenous leukemia can be reduced significantly by empirical treatment with amphotericin B.

Key words

Leukemia Lymphoma Fever Neutropenia Mycosis Antibiotics, antifungal Autopsy Retrospective studies Comparative studies 

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • M. B. Zimmermann-Hösli
    • 1
  • R. A. Stahel
    • 1
  • P. Vogt
    • 1
  • O. Oelz
    • 1
  1. 1.Departement für Innere Medizin, Medizinische Klinik und Institut für PathologieUniversitätsspital ZürichSchweiz

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