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May 10, 1976

Managing Systemic Mycoses in the Compromised Host

Author Affiliations

From the Department of Surgery, Harvard Medical School, Boston (Dr Codish), and the Department of Medical Oncology, St Bartholomew's Hospital, London (Dr Tobias).

JAMA. 1976;235(19):2132-2134. doi:10.1001/jama.1976.03260450044033

IMMUNOSUPPRESSIVE therapy is now being used more frequently as a result of its proved value in several areas of medicine. Infection secondary to impaired resistance is the major cause of morbidity and mortality in patients treated with these agents.1-5 Fatal infections following immunosuppression are most often seen in patients with advanced malignant disease or after transplantation, and the incidence of infection is greater in patients receiving steroids, antilymphocyte serum, and combination antineoplastic chemotherapy.2,4,5

Candida  Candida is the most frequently encountered fungus in cancer and transplant patients.2,6,7 Antibacterial agents have a special role in candidiasis since they increase colonization of the skin and mucous membranes with Candida species, particularly C albicans.8 Localizing symptoms of candidiasis are usually confined to the distal esophagus or bladder but sometimes result from endophthalmitis, meningitis, arthritis, perforation of an abdominal viscus, or emboli from endocarditis.8,9 Roentgenographic evidence of Candida pneumonitis typically