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Fungal Pneumonia and Severe Neutropenia: Risk Factors for Increased 90 Day Mortality

Summary

This study examined 39 cancer patients with severe fungal lung infections treated at a major cancer center. Patients who received antifungal treatment within 7 days and started with a specific drug called liposomal amphotericin B had better survival rates at 90 days. The research suggests that quick diagnosis and prompt treatment initiation are critical for improving survival in immunocompromised patients with fungal pneumonia.

Background

Invasive fungal infections (IFI) carry high mortality risk in patients with hematologic malignancy, with most infections being pulmonary. Previous studies showed increased mortality associated with delays in therapy and failure of neutrophil recovery. Recent use of salvage posaconazole may have improved outcomes in these critically ill patients.

Objective

To identify risk factors associated with higher 90-day mortality in patients with hematologic malignancy, severe neutropenia, and diagnosis of invasive fungal pneumonia treated with posaconazole.

Results

90-day mortality was 56.0% (n=14). Survivors were more likely to have antifungal therapy initiated within 7 days (96.0% vs 64.3%, p=0.016) and received liposomal amphotericin B as initial therapy (72.0% vs 42.9%, p=0.009). Combination therapy and granulocyte colony-stimulating factors were not associated with improved outcomes.

Conclusion

Early recognition and initiation of antifungal therapy within 7 days in high-risk neutropenic patients and initial regimens including liposomal amphotericin B may be associated with improved 90-day survival outcomes in fungal pneumonia.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Retrospective Cohort Study,
  • Source: 10.1093/ofid/ofae631.1214
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