Entries by Amar Safdar

CHAPTER 30. Cytomegalovirus in Patients with Cancer by Morgan Hakki, Per Ljungman, Michael Boeckh

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ABSTRACT Human cytomegalovirus (CMV) is a common opportunistic infection after hematopoietic cell transplant (HCT) and is less frequently encountered among patients undergoing cytotoxic chemotherapy for various malignancies. Both primary infection and reactivation can result in substantial morbidity and mortality in the immunocompromised host. Therefore, the prompt recognition and treatment of CMV infection is critical. This […]

CHAPTER 29. Immunotherapy for difficult to treat invasive fungal diseases by Brahm H. Segal, Amar Safdar, David A. Stevens

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ABSTRACT Opportunistic fungal diseases occur most commonly in highly immunocompromised patients, such as those with prolonged neutropenia or transplant recipients treated with intensive immunosuppression. Significant advances have been made in antifungal agents, which have led to improved therapeutic outcomes as well as a greater emphasis on antifungal prophylaxis targeted to the highly immuncompromised. In addition, […]

CHAPTER 28. Fungal Drug Resistance and Pharmacologic Considerations of Dosing Newer Antifungal Therapies by Russell E. Lewis, David S. Perlin

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ABSTRACT Recent advances in hematopoetic cell transplantation and a broadening array of salvage chemotherapy options have extended the survival of patients with hematological cancers, but can result in prolonged periods of immunosuppression and susceptibility to invasive fungal infections.  Among these high-risk patient populations, systemic antifungal therapy is administered episodically or sometimes continuously for months or […]

CHAPTER 27. Current Controversies in the Treatment of Fungal Infections by Christopher D. Pfeiffer, John R. Perfect, Barbara D. Alexander

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ABSTRACT With improved laboratory techniques and the availability of new antifungal agents, complexity in the treatment of invasive fungal disease has rapidly increased over the past decade, stimulating a debate on the best management strategies.  In this chapter, we address four important areas of current uncertainty, including: 1) the role of therapeutic drug monitoring for […]

CHAPTER 26. Cryptococcal Disease and Endemic Mycosis by Johan A. Maertens and Hélène Schoemans

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ABSTRACT Cryptococcus and the endemic fungi (Histoplasma, Blastomyces and Coccidioides) can cause severe, even life-threatening pulmonary and extrapulmonary disease in immunocompromised patients, including cancer patients and transplant recipients. This chapter describes the epidemiology, clinical manifestations, diagnosis and treatment of these infections in patients with prolonged immunodeficiency.

CHAPTER 25. Management of Aspergillosis, Zygomycosis, and Other Clinically Relevant Mold Infections by Konstantinos Leventakos, Dimitrios P. Kontoyiannis  

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ABSTRACT Invasive mold infections (IMIs) are a major cause of morbidity and mortality in severely immunocompromised hematologic malignancy patients and hematopoietic stem cell transplantations recipients. Invasive aspergillosis caused by Aspergillus fumigatus is the most common cause of IMI, but recent advances in the pharmacotherapy of fungal infections and an increase in the number of patients […]

CHAPTER 24. Invasive Candidiasis by Matteo Bassetti,  Malgorzata Mikulska, Juan Gea-Banacloche, Claudio Viscoli

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ABSTRACT Candida infections are increasing. Non-albicans Candida are now the most commonly isolated species in immunocompromised patients. The determination of serum beta-D-glucan may allow early diagnosis but the best implementation of this new technology as screening or diagnostic test remains to be determined. From the therapeutic standpoint, the echinocandins have changed the management of invasive […]

CHAPTER 23. Diagnosis of Invasive Fungal Disease by Dionissios Neofytos, Kieren Marr

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ABSTRACT The diagnosis of invasive fungal infections (IFI) relies on the critical assessment of clinical presentation, associated risk factors, and careful interpretation of the appropriate diagnostic tests.  Frequently, clinicians have to initiate antifungal therapy based on their clinical suspicion and without having made a definitive diagnosis, particularly in cancer or other critically ill patients.  To […]

CHAPTER 22. Overview of Invasive Fungal Disease in Oncology Patients by Amar Safdar

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ABSTRACT The spectrum of invasive fungal disease has changed considerably in the past two decade. Since late 1980’s triazole prophylaxis has resulted in a significant decline in cases of invasive candidiasis among patients undergoing hematopoietic stem cell transplantation and those with acute leukemia. Recently, reduced rates of invasive mold disease following echinocandin and anti-mold triazoles […]

CHAPTER 21. Skin Disorders Difficult to Distinguish from Infection by Sharon Hymes, Susan Chon, Ana Ciurea

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ABSTRACT Dermatologists and infectious disease specialists are often called upon to evaluate skin lesions in cancer patients, especially when an infectious etiology is suspected.  Many different organisms can affect the skin, and these are comprehensively reviewed in other chapters. This section will review some of the non-infectious skin eruptions that mimic cutaneous infections. These non-infectious […]