Table 1. Clinicalandlaboratorycharacterisitics of Thepatientswithinvasivefungaldiseases
Table 1. Clinicalandlaboratorycharacterisitics of thepatientswithinvasivefungaldiseases
Age/Gender / Hematologicdisease / Antifungalexposurebeforetesting / Neutrophil count (x109l-1) when serum was obtained / GM / GMa / LFD / BDG (pg/ml) / Radiological finding on thoracic CT / EORTC/MSG classification / Antifungaltherapyandclinicaloutcome
1 / 22/ Male / ALL / Fluconazole / 0.35 / 0.20 / 0.47 / Negative / 251 / Nodulewithhalo / ProbableFungalDisease / Successundervoriconazoletherapy, dischargedfromhospital in goodcondition
2 / 18/ Male / ALL/ASCT / Fluconazole / 0.45 / 0.19 / 1.24 / Negative / 39 / Nodulewithhalo / Probable IA / Successundervoriconazoletherapy, dischargedfromhospital in goodcondition
3 / 42/ Male / AML / Fluconazole / 0.36 / 0.16 / 1.23 / Negative / 192 / Nodulewithhalo / Probable IA / Progressionundervoriconazoletherapy, primarydiseasewasrefractorytochemotherapy, died
4 / 43/ Male / AML / Posaconazole / 0.3 / 0.20 / 0.98 / Negative / 101 / Nodule / Probable IA / Successundervoriconazoletherapy, dischargedfromhospital in goodcondition
5 / 49/ Male / AML / Posaconazole / 0.07 / 0.18 / 1.65 / Strongpositive / 104 / Nodulewithhalo / Probable IA / Successunderposaconazoletherapy, dischargedfromhospital in goodcondition
6 / 18/ Female / AML / Posaconazole / 0.09 / 0.13 / 0.98 / Negative / <7 / Nodulewithhalo / Probable IA / Successundercaspofungintherapy, dischargedfromhospital in goodcondition
7 / 18/ Male / ALL/ASCT / Fluconazole / 0.02 / 0.16 / 1.38 / Negative / 10 / Nodulewithhalo / Probable IA / Successundervoriconazoletherapy, dischargedfromhospital in goodcondition
8 / 49/ Female / AML / Posaconazole / 0.12 / 0.72 / 1.76 / Negative / 25 / Noduleandcavitation / Probable IA / Successundercaspofungintherapy, dischargedfromhospital in goodcondition
9 / 48 / Male / AML / Posaconozale / 0.13 / 0.10 / 1.78 / Negative / 108 / Nodulewithhalo / Probable IA / Successundercaspofungintherapy, dischargedfromhospital in goodcondition
10 / 20/ Female / ALL / Fluconazole / 0.07 / 0.10 / 1.15 / Negative / 15 / Nodule with halo / Probable IA / Skin rushafterthefirstdose of voriconazoleandswitchedtoliposomalamphotericin B, BAL fluidwasobtainedaftertwodays of antifungaltherapy, BAL LFD wasmoderatepositive, nodularlesioncompletelyresolvedunderantifungaltherapy (Figure 2)
Amphotericin B / 0.09 / 0.10 / 1.05 / Negative (BAL LFD moderatepositive) / 36
(BAL BDG 90 pg/mL)
11 / 49/ Male / ALL / Fluconazole / 0.02 / 3.33 / 6.1 / Negative* / 176 / Nodule with halo and cavitation / Probable IA / Progressionundervoriconazoletherapy, andthenswitchedtoliposomalamphotericin B. After 10 days,he refusedanyintravenoustherapyanddischargedwith oral voriconazole
12 / 58/ Female / ALL/ASCT / Amphotericin B / 0.02 / 0.81 / 1.98 / Negative / 57 / Nodule / Probable IA / Progressionunderempiricalliposomalamphotericin B therapy, succeededaftersecondswitchtovoriconazole, discharged in goodclinicalcondition
13 / 53/ Female / ALL / Fluconazole / 0.03 / 0.27 / 0.65 / Negative / 42 / Bone-dextruction at paranasal CT
Leptomeningealenhancement atcranial MRI / Rhinocerebralaspergillosis / Diedunderliposomalamphotericin B therapy. Primarydiseasewasrefractorytochemotherapy
Amphotericin B / 0.04 / 0.48
(3.27 from CSF) / 1.54 / Negative / 83
14 / 23 / Male / AML / Posaconazole / 0.02 / 0.16 / 0.17 / Negative / >523 / Normal / Blastoschizomycescapitatus fungemia / Liposomalamphotericin B wasthefirstlinetherapy. Althoughbloodculturesbecamenegative, feverpersistedandresolvedafter a secondswitchto voriconazole, patientwasdischargedin goodclinicalcondition
15 / 24/ Male / ALL / Caspofungin / 0.03 / 0.20 / 0.21 / Negative / 117 / Normal / Non-albicanscandidafungemia / Caspofunginwasstartedempirically. Patientwastransferedtointensivecareunit, anddiedwithmultiorganfailure
*Aspergillus-LFD wasmoderatepositivewhen serum wastestedafterthepretreatmentprocedure.
ALL; acutelymphocyticleukaemia, AML; acutemyelogenousleukaemia, ASCT; Allogeneicstemcelltransplantation, BAL; bronchoalveolarlavage , CT; computedtomography, CSF; Cerebrospinalfluid, EORTC/MSG; EuropeanOrganizationforResearchandTreatment of CancerandtheMycosesStudyGroup , GM; galactomannan, GMa; Galactomannanindexobtainedwithmodifiedmethodology, IA; InvasiveAspergillosis, LFD; lateralflow device, MRI; magneticresonanceimaging