When and which fungal pathogens should come to mind in patients with hematological malignancies

We retrospectively evaluated the febrile neutropenia episodes of hematological patients and their outcomes with respect to fungal pathogens and antifungal therapy. The study covers all consecutive patients older than 14 years of age and who developed febrile neutropenia episodes from September 2011 and September 2012. 68 consecutive patients with neutropenia and their 129 febrile episodes were analyzed. Mean age was 59.36±15.22 years (range: 17-80 years) and 41 cases were male. MASCC score was 19.56 ± 9.04 in the patients with hematological malignancies. VOR, CAS and AM-B were used to treat in 40 episodes of 40 patients, 34 episodes of 27 patients and 12 episodes of 12 patients as first-line therapy, respectively. Candida albicans is still dominant in hematological patients followed by other non-albican Candida species that leads to fatal outcome in patients with history of azole exposure. Design and equipments (HEPA filter, single-room design, etc.) of hematology ward are very important for environmental contamination by Aspergillus spp. that leads to mortal and common invasive fungal infections in patient with hematological malignancies.