Treatment of fungal and other opportunistic infections in immunocompromised patients.

Significant improvements have been made with regard to infection-related mortality in patients with underlying immune deficiencies. Many factors predispose these patients to infection, including the incidence of profound and persistent neutropenia, but with resolution of the immune suppression the majority of these patients will survive their neutropenic period. Although most initial infections are caused by bacterial pathogens, most subsequent infections are due to fungal organisms. The mortality rate continues to be very high for immunocompromised patients who develop infection with Candida and Aspergillus. Fungal infections remain difficult to diagnose; antifungal therapy alternatives are inadequate, and these infections remain a major prevention and treatment challenge for immunocompromised patients. For the future, novel approaches that improve standard therapy, incorporate cytokines and growth factors, or focus on preventive measures offer the most effective way to deal with fungal infections.