Invasive fungal disease in hemato-oncology patients with febrile neutropenia in a public center in Santiago, Chile

Abstract

Background: Invasive fungal disease (IFD) is a serious infectious complication among hemato-oncological (H-O) patients, but there is limited regional information available. Aim: To describe the clinical and microbiological characteristics of invasive fungal infection (IFI) episodes in H-O patients with chemotherapy-associated febrile neutropenia (FN) in a Chilean public hospital. Methods: We included patients with hematological neoplasia, ≥ 15 years old, who presented FN and suspected IFD over a 2-year period. Demographic data, hematologic pathology, clinical and mycological criteria for IFD, and discharge status were recorded. The level of diagnostic certainty was established according to EORTC/MSG 2008 criteria. Results: 30 episodes of IFD were identified in 26 patients. The mean age was 42.7 (± 16.3) years. Proven IFD accounted for 23.3%, probable IFD for 13.3%, and possible IFD for 63.3%. In 26 cases, aspergillosis was diagnosed, being the most common IFD. The intrahospital mortality rate was 23.3%. Discussion and Conclusions: These findings highlight the complexity and diagnostic and therapeutic challenges of IFDs in this population. It is crucial to improve diagnostic methods, therapeutic management, and conduct prospective studies to optimize the approach to IFDs in H-O patients.