# Opportunistic Fungi in Cancer and Hematopoietic Stem-Cell Transplant Patients: Diagnosis and Management Strategies
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Diagnosis of IFI in cancer and HSCT patients is difficult.25 Nonetheless, early diagnosis is essential, as the survival of patients often depends on prompt institution of appropriate therapeutic measures. The diagnostic challenges are many. Some are referrable to fungal infections per se while some are associated with antineoplastic therapy and the HSCT process itself. Meeting these challenges successfully requires a high index of clinical suspicion. Knowledge of the spectrum of presentations that occur in IFI, the natural history of these infections, and the pathogens likely to be present can help raise the requisite degree of suspicion and guide diagnostic efforts.

As previously noted, infections are generally predictable and correlated to sequential changes in host immune defenses. Many important clinical and radiologic signs of IFI also parallel changes in immune status that occur over time. Thus, an awareness of the correlation between immune status, disease manifestations, and the time elapsed after receipt of myeloablative chemotherapy or HSCT enables physicians to focus their diagnostic efforts on measures most likely to lead to a prompt diagnosis.

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   Clinical Evaluation: History
   Clinical Evaluation: Physical Examination
   Azole Antifungal Agents
       New Azoles Undergoing Clinical Trials
   Culture of Fungal Pathogens
   Testing for Fungal Antigens and DNA

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Course Number: V035D

This CME Expires on July 1, 2005; no tests will be accepted after this date.

This course is accredited by The University of Pittsburgh School of Medicine, Center for Continuing Education and The International Immunocompromised Host Society

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