Fungal Infections in the Immunocompromised Host

Clinical Syndromes and Diagnosis
  • Herman Chmel
Part of the Infectious Agents and Pathogenesis book series (IAPA)


Fungal infections are a major cause of morbidity and mortality in the immunocompromised host. In the last 25 years, the frequency of invasive fungal infections has increased remarkably. Unbiased data concerning the true incidence and prevalence of invasive fungal infections in different patient populations is limited. Hart et al.1 reported 132 invasive fungal infections in normal and immunocompromised patients. Seventy infections occurred in immunocompromised patients, 81% caused by Candida spp., Aspergillus spp., and Zygomycete spp. and 12% by Cryptococcus spp. In contrast, 62 invasive fungal infections occurred in normal patients, and none were caused by Candida, Aspergillus, or Zygomycete spp. Muller et al. 2 reported the following incidence of opportunistic deep-seated mycosis, candidiasis 92.6%; aspergillosis 6.7%; cryptococcosis 0.35%, and zygomycosis 0.35%. Rose and Varkey,3 in a comprehensive review of invasive fungal infections, reported per 10,000 hospital discharges the following rates: Candida spp. 7.08, Aspergillus spp. 1.4, and Zygomycete spp. 0.23. Data from the National Nosocomial Infection Surveillance Program (CDC)4 representing 1984 rates showed Candida spp. accounted for 5.5% of all isolates and was the eighth most common nosocomial pathogen. The category listed as “other fungi” accounted for 1.7% of all isolates and ranked 11th. Although data from autopsies are limited and selective, the relative frequency of invasive fungal infections in transplant and oncologic patients can be inferred by their review. The observed frequency of invasive fungal infections is 20–30% in patients with acute leukemia, 10–15% in patients with lymphoma, and 5% in patients with other malignancies.5 The frequency in organ transplant recipients is 28–42% for liver, 10–35% for heart, 2–30% for bone marrow, and 0–20% for kidneys.6 Overall invasive candidiasis accounted for death in 10–40% of patients and invasive aspergillosis in 5–15%.7


Catheter Pneumonia Meningitis Fusarium Mannose 


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Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Herman Chmel
    • 1
  1. 1.Division of Infectious and Tropical Diseases, Department of Internal Medicine, College of MedicineUniversity of South FloridaTampaUSA

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