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Molecules 2014, 19(1), 1085-1119; doi:10.3390/molecules19011085

Invasive Fungal Infections in the ICU: How to Approach, How to Treat

* , , ,  and
Department of Critical Care Medicine, University Hospital ATTIKON, Medical School of Athens, Haidari 12462, Greece
* Author to whom correspondence should be addressed.
Received: 1 November 2013 / Revised: 3 January 2014 / Accepted: 9 January 2014 / Published: 17 January 2014
(This article belongs to the Special Issue Advances in Medicinal Chemistry of Antifungals)
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Invasive fungal infections are a growing problem in critically ill patients and are associated with increased morbidity and mortality. Most of them are due to Candida species, especially Candida albicans. Invasive candidiasis includes candidaemia, disseminated candidiasis with deep organ involvement and chronic disseminated candidiasis. During the last decades rare pathogenic fungi, such as Aspergillus species, Zygomycetes, Fusarium species and Scedosporium have also emerged. Timely diagnosis and proper treatment are of paramount importance for a favorable outcome. Besides blood cultures, several laboratory tests have been developed in the hope of facilitating an earlier detection of infection. The antifungal armamentarium has also been expanded allowing a treatment choice tailored to individual patients’ needs. The physician can choose among the old class of polyenes, the older and newer azoles and the echinocandins. Factors related to patient’s clinical situation and present co-morbidities, local epidemiology data and purpose of treatment (prophylactic, pre-emptive, empiric or definitive) should be taken into account for the appropriate choice of antifungal agent.
Keywords: Candida infections; intensive care unit; fungi Candida infections; intensive care unit; fungi
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Paramythiotou, E.; Frantzeskaki, F.; Flevari, A.; Armaganidis, A.; Dimopoulos, G. Invasive Fungal Infections in the ICU: How to Approach, How to Treat. Molecules 2014, 19, 1085-1119.

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