Severe Fungal and Parasitic Infections in the Intensive Care Unit

Abstract

The recent advances in intensive care medicine have contributed to longer survival of the patients, which has led to an increasing incidence of opportunistic infectious diseases caused by fungi. Invasive fungal infections are becoming a problem in the critical care setting because of its associated morbidity and mortality. While most of the infections are due to Candida species, other rare pathogenic fungi are emerging, including the order Mucorales or Aspergillus species. Early diagnosis and treatment of these infections are essential to improve the outcomes. In this chapter, we will address two representative fungal infections in the Intensive Care Unit (ICU): candidemia/invasive candidiasis and mucormycosis.

Although parasitic infections are uncommon in the ICUs of the developed world, the increase in air travel and tourism and the recent changes in the pattern of migratory movements have led to an increased exposure of individuals to these infectious agents. Thus, thinking of these diseases can be life saving. Suspecting malaria may not be straightforward; however, the treatment of severe malaria is a medical emergency. Other parasitic infections, such as echinococcal disease, can evolve to multiple organ failure and require a multidisciplinary management, where supportive therapy in the ICU may have a central role. In this chapter, we will focus on two relevant parasitic infections in the ICU: malaria and echinococcal disease.