عفونتهای قارچی فرصت طلب در مبتلایان به بدخیمی های خونی و گیرندگان پیوند مغز استخوان

BMT recipients experience severe immunodeficiency as a consequence of pre transplant radiation and chemotherapy, transient granulocytopenia before BMT, and post-transplant prevention and treatment of graft-versus-host disease with immunosupressive agents. So, opportunistic organisms including candida, aspergillus, mcor, and fusarium species, dematiaseous fungi and other usually “nonpathogenic” fungi, have reported as the causative agents of local and systemic disease in these severely immunocompromised patients and have become a major source of morbidity and mortality. During 12 month, 32 patients who underwent BMT, evaluated for: 1) fungal normal flora on hospitalization, 2) fungal colonization and infection before and after BMT. Underlying disease in these patients included: leukemia in 15 patients, major thalasemia in 12, aplastic anemia in three and fanconi’s anemia in two patients. All patients on the BMT ward underwent regular serveillance cultures at admission and then once every two weeks. Similar examinations was performed, if they had clinical features. 719 specimens (138 throat and buccal mucosa, 103 ear and nose, 135 stool and rectal swab, 123 urine, 74 blood, 47 skin, 57 vaginal discharge and 43 sputum, bronchoalveoalr lavage fluid and tracheal aspirate) from these patients were examined routinely by direct test and culture methods. In this study in 9 BMT recipients, clinincal features suggested fungal infection, were observed (for one or two times) that in direct test and culture method, fungal agents were isolated. These agents included: Candida spp. 10 cases (76.9%), Geotrichum candidum one case (7.6%), Cryptococcus albidus one case, and unknown yeasts in one case. Also, the fungal colonization were observed in 9 cases, (6 cases before BMT and 3 cases after BMT). All of these patients were treated by Amphotericin-B and Nystatin.