Author/Editor		Zver, Samo
Title		Invazivne glivične okužbe - naše izkušnje pri diagnostiki in zdravljenju
Translated title		Our experiences with diagnostics and treatment of invasive fungal infections
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 5
Publication year		2000
Volume		str. 213-20
Language		slo
Abstract		Invasive fungal infections (IFI) are one of the most frequent complications during the treatment of critically neutropenic hematological patients. Other common risk factors for the development of IFI are treatment with immunosupresive drugs, especially corticosteroids and purine analogues, older age of the patients, prolonged previous treatment with antibiotics, reconstructive works in the hospital surroundings, cytomegalovirus infection etc. The most frequent IFI are candidiasis and aspergillosis. In the period between 1. 4,1998 and 1. 4. 2000 fifteen patients with acute and chronic leukemia and hairy cell leukemia were diagnosed with IFI at our hematological department. In 11/15 patients (73%) we diagnosed aspergillosis, in 3/15 patients (20%) candidiasis and in 2/15 (13%) infection with Acremonium and Fusarium species. One patient had simultaneus candidiasis and aspergillosis. Risk factors for the developement of IFI in our patients, diagnostic procedure and treatment are described. We have noticed worrying increase of asperillosis incidence at our department after some minor reconstruction work was performed. Because the treatment of established IFI is rarely effective, we need to improve our preventive measures (special air filters) and early IFI diagnosis.
Summary		Invazivne glivične okužbe (IGO) so eden najpogostejših zapletov pri zdravljenju kritično nevtropeničnih hematoloških bolnikov. Ostali pogosti dejavniki tveganja za razvoj IGO so še zdravljenje z imunosupresivnimi zdravili, predvsem kortikosteroidi in analogi purina, visoka starost bolnikov, predhodno daljše zdravljenje z antibiotiki, gradbena dela v okolici bolnišnice, okužba s citomegalovirusom... Najpogostejši IGO sta kandidiaza in aspergiloza. V obdobju med 1. 4.1998 in 1. 4. 2000 smo na kliničnem oddelku za hematologijo diagnosticirali IGO pri petnajstih bolnikih, ki so se zdravili zaradi akutne levkemije, kronične mieloične in limfatične levkemije in dlakastocelične levkemije. Pri 11/15 (73 %) bolnikih smo ugotavljali aspergilozo, pri 3115 (20 %) kandidiazo in pri 2i15 (13 %) okužbo z glivo iz vrste acremonium oz. fusarium. En bolnik je imel sočasno kandidiazo in aspergilozo. Opisani so dejavniki tveganja ob nastanku IGO pri obolelih, diagnostični postopek, zdravljenje in učinek zdravljenja. Opažamo kritičen porast števila aspergiloz na hematološkem oddelku, potem ko so bila predhodno opravljena manjša vzdrževalna dela. Ker je zdravljenje IGO pogosto neuspešno, je v prihodnosti potreben poseben poudarek na preventivi (posebni zračni filtri) in pa zgodnji diagnostiki IGO.
Descriptors		MYCOSES CANDIDIASIS ASPERGILLOSIS ASPERGILLUS FUMIGATUS LEUKEMIA