web analytics

Description

The Invasive Fungal Infection Cooperative Group (IFICG) of the European Organization for Research and Treatment of Cancer (EORTC) and the Mycoses Study Group of the National Institute of Allergy and Infectious Diseases (NIAID) have defined clinical findings associated with invasive opportunistic fungal infections in a patient with cancer or an hematopoietic stem cell transplant.


 

Categories of findings:

(1) lower respiratory tract infection (LRTI)

(2) sinonasal infection

(3) CNS infection

(4) disseminated infection

 

Lower respiratory tract infection -Major criteria:

(1) new infiltrate with halo sign

(2) new infiltrate with air-crescent sign

(3) new infiltrate with a cavity in an area of consolidation

 

where:

• Diagnosis of a lower respiratory tract infection requires exclusion of other organisms that can cause similar findings: Mycobacteria, Nocardia and Legionella.

 

Lower respiratory tract infection - Minor criteria:

(1) cough, chest pain, dyspnea and/or hemoptysis

(2) pleural rub

(3) any new infiltrate not meeting the major criteria

(4) pleural effusion

 

Sinonasal infection - Major criteria:

(1) radiographic evidence of invasive infection in sinus (erosions of sinus walls, extension into adjacent structures, destruction along skull base)

 

Sinonasal infection - Minor criteria:

(1) upper respiratory tract symptoms (nasal discharge, stuffiness)

(2) nasal ulceration or eschar

(3) epistaxis

(4) periorbital swelling

(5) maxillary tenderness

(6) black necrotic lesions or perforation of the hard palate

 

CNS infection - Major criteria:

(1) radiographic evidence of mastoiditis or other parameningeal focus

(2) extradural empyema

(3) intraparenchymal mass lesion in the brain or spinal cord

 

CNS infection - Minor criteria:

(1) focal neurological symptoms and signs (focal seizures, hemiparesis, cranial nerve palsy)

(2) mental changes

(3) meningeal irritation

(4) abnormal CSF with bacterial and viral cultures negative and no evidence of malignant cells

 

Disseminated infection - Major criteria:

(1) new onset of papular or nodular skin lesions without other explanation

(2) intra-ocular findings suggestive of hematogenous fungal chorioretinitis or endophthalmitis

(3) small, peripheral target-like abscesses ("bull's eye" lesions) in liver and/or spleen (suggest disseminated candidemia)

 


To read more or access our algorithms and calculators, please log in or register.