Current clinical issues on mycoses in neutropenic patients.

Invasive fungal infections, which are associated with high morbidity and mortality rates, are an increasing challenge for the management of immunocompromised hosts, particularly neutropenic cancer patients. Due to the ageing population, recent progress in cancer therapy and better prognosis of bacterial infections, the numbers of patients at risk of life-threatening mycoses are increasing. The percentage of cancer patients with evidence of an invasive fungal infection ranges from approximately 5% to 30%. The most common opportunistic fungal pathogens are Candida spp. and Aspergillus spp. but recently unusual pathogens including Fusarium, Trichosporon and many others have been increasingly reported. Although some progress has been made in the last decade, several controversial issues need to be addressed by clinicians as well as by medical microbiologists and mycologists involved in the care of patients experiencing fungal infections. A comprehensive clinical strategy, such as that initiated under the auspices of EORTC is a meaningful approach to ensure high quality clinical research in that field in order to define guidelines for more effective diagnosis, prevention and treatment approaches of invasive fungal infections in cancer patients at the European level.