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Diagnosis of invasive fungal infections in hematology and oncology

Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

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Abstract

Invasive fungal infections are a primary cause of morbidity and mortality in patients with hematological malignancies. Establishing a definite diagnosis of invasive fungal infection in febrile neutropenic patients is particularly challenging and time-consuming, but a delay of antifungal treatment leads to higher mortality. This situation has lead to the strategy of initiation "empirical" antifungal therapy prior to the detection of fungi. Meanwhile, improvements in diagnostic procedures are achieved, especially with imaging techniques and non-culture based methods which include antigen-based assays, metabolite detection and molecular detection of fungal DNA from body fluid samples using conserved or specific genome sequences. The AGIHO presents recommendations for the diagnosis of invasive fungal infections with risk-adapted screening concepts for the neutropenic and febrile episodes of patients with hemato-oncological disorders.

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Acknowledgements

A. Böhme was supported by the Federal Ministry of Education and Research, Competence Network for Acute and Chronic Leukemias, Federal Republic of Germany, Grant No 01GI 9971.

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Authors and Affiliations

  1. Dept. of Medicine, Div. Onkology/Hematology, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Schumannstrasse 20-21, 10117, Berlin, Germany

    M. Ruhnke

  2. Dept. of Internal Medicine, Med. Clinic III, Hematology/Oncology/Infectious Diseases/Rheumatology , J.W. Goethe University, Frankfurt/Main, Germany

    A. Böhme

  3. Dept. III. of Internal Medicine, Mannheim University Hospital, University of Heidelberg, Mannheim, Germany

    D. Buchheidt

  4. Institute of Pathology, Municipal Hospital of Braunschweig, Braunschweig, Germany

    K. Donhuijsen

  5. Dept. of Internal Medicine, Med. Clinic II, Hematology/Oncology/Rheumatology, Eberhard-Karls-Universität, Tübingen, Germany

    H. Einsele

  6. Institute of Medical Microbiology, J.W. Goethe University, Frankfurt/Main, Germany

    R. Enzensberger

  7. Dept. of Internal Medicine, Med. Clinic and Policlinic I, University Hospital, Bonn, Germany

    A. Glasmacher

  8. Dept. of Ophthalmology, Academic Bundeswehr-Clinic, Ulm, Germany

    H. Gümbel

  9. Dept. of Radiology, Johannes Gutenberg-University, Mainz, Germany

    C.-P. Heussel

  10. Dept. of Internal Medicine, Med. Clinic II, Ev. Johannes-Krankenhaus, Bielefeld

    M. Karthaus

  11. Institute of Pathology, J.W. Goethe University, Frankfurt/Main, Germany

    E. Lambrecht

  12. Dept. of Internal Medicine, Ruhr-University Bochum, Knappschaftskrankenhaus, Bochum, Germany

    T. Südhoff

  13. Dept. of Internal Medicine, Hematology/Oncology/Transfusion Medicine, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany

    H. Szelényi

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  1. M. Ruhnke
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  2. A. Böhme
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  3. D. Buchheidt
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  4. K. Donhuijsen
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  9. C.-P. Heussel
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Correspondence to M. Ruhnke.

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Ruhnke, M., Böhme, A., Buchheidt, D. et al. Diagnosis of invasive fungal infections in hematology and oncology. Ann Hematol 82 (Suppl 2), S141–S148 (2003). https://doi.org/10.1007/s00277-003-0768-0

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  • DOI: https://doi.org/10.1007/s00277-003-0768-0

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