Abstract
In recent years the frequency of disseminated or visceral opportunistic fungal infection has been increased. Unfortunately, the early diagnosis of these serious infections is very difficult for several reasons, and even when the infection is diagnosed, treatment options are limited to a few drugs. It is therefore necessary to establish a method of diagnosis and treatment of these fungal deseases in an early clinical stage to control them.
We report here the result of investigations on the therapeutic effect of fluconazole (FLCZ) in patients with hematological disorders. Two hundred patients admitted to Kitasato University Hospital Department of Hematology from July 1989 through April 1991 were studied. Sixty-nine cases were diagnosed as fungal infection according to a flow chart used based on clinical findings, immunological and cultural examinations and a risk index for leukemia.
Diagnosed or suspected cases were treated with 50-400mg/day of FLCZ by oral or intravenous administration and the therapeutic effect was evaluated by clinically and by immunological and mycological laboratory data.
Except for 39 patients who could not be evaluated, 20 patients were diagnosed and 10 patients were suspected as fungal infection, and FLCZ has been administered to both diagnosed and suspected cases. Diagnosed cases consisted of 19 cases with Candidiasis and 1 case with Trichosporosis. Effective rate of FLCZ showed 80% in the diagnosed cases. Mean of cumulative doses and term of administration of FLCZ against the diagnosed cased were 3637.5mg and 18.8days, respectively. At the suspected cases results were suggested that FLCZ had prophylactic effect. We emphasize that it is important to the diagnose and the antifungal therapy in early clinical stage to control fungal infection and FLCZ has effectiveness for disseminated or visceral fungal infection.
