Fungal empyema thoracis in cancer patients

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dc.contributor.authorNigo, Masayuki
dc.contributor.authorVial, Macarena
dc.contributor.authorMunita, José
dc.contributor.authorJiang, Ying
dc.contributor.authorTarrand, Jeffrey
dc.contributor.authorJimenez, Carlos
dc.contributor.authorKontoyiannis, Dimitrios
dc.date.accessioned2017-05-15T13:44:14Z
dc.date.available2017-05-15T13:44:14Z
dc.date.issued2016
dc.description.abstractOBJECTIVES: Fungal empyema thoracis (FET) is a rare life-threatening infection. We sought to describe the clinical characteristics of FET in a large academic cancer center. METHODS: We conducted a retrospective chart review of all cancer patients who had a fungal isolate from the pleural fluid culture between 1/2005 and 8/2013. RESULTS: A total of 106 fungal isolates were identified in 97 patients. Yeasts accounted for 62% of the isolates whereas 38% were identified as molds. The most frequent pathogens were Candida spp. (58%) and Aspergillus spp. (12%). All patients with Aspergillus and 83% with Candida met criteria for proven fungal disease. Compared to the Aspergillus group, Candida FET was associated with recent abdominal or thoracic surgical procedures (44% vs. 0%, p = 0.01). Overall, 6-week mortality was high, with no significant differences between Candida and Aspergillus (31% vs. 45%, respectively [p = 0.48]). Only 1 out of 11 patients with uncommon molds died at 6 weeks, despite only 2 of them received appropriate antifungal therapy. CONCLUSIONS: Development of FET carries a high mortality in cancer patients. A history of a recent surgical procedure is a risk factor for FET due to Candida. Isolation of uncommon molds is likely to represent a contamination of the pleural fluid.
dc.format.extent7
dc.identifier.citationJ Infect. 2016 May;72(5):615-21
dc.identifier.urihttp://hdl.handle.net/11447/1241
dc.identifier.urihttp://dx.doi.org/10.1016/j.jinf.2016.02.014
dc.language.isoen_US
dc.publisherElsevier
dc.subjectCancer
dc.subjectEmpyema
dc.subjectFungal empyema
dc.subjectInvasive fungal infection
dc.titleFungal empyema thoracis in cancer patients
dc.typeArtículo

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