Diagnose und Therapie von Pilzinfektionen und der Pneumozystis-Pneumonie bei Kindern und Jugendlichen mit neoplastischen Erkrankungen

Zusammenfassung

Invasive Pilzinfektionen sind eine wichtige Ursache von Morbidität und Mortalität krebskranker Kinder und Jugendlicher mit intensiv chemotherapeutisch behandelten hämatologischen Neoplasien und nach allogener hämatopoetischer Stammzelltransplantation. Die vorliegende Arbeit enthält umfassende Empfehlungen der Arbeitsgruppe „Infektionen bei immunsupprimierten Kindern” der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) und der Deutschen Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) zu Diagnose und Behandlung invasiver und oberflächlicher Pilzinfektionen sowie der Pneumocystis-jiroveci-Pneumonie. Sie basieren auf der speziellen Pharmakologie und dem Zulassungsstatus bei pädiatrischen Patienten sowie klinischen Studien, Fallserien und Expertenmeinungen analog den Evidenz-Kriterien der Infectious Diseases Society of America (IDSA). Die Empfehlungen für die häufigsten klinischen Entitäten sind hier zusammengefasst. Optionen zur Initialtherapie der unkomplizierten Candidämie umfassen Deoxycholat Amphotericin B (DAMB), Fluconazol (FLC), liposomales Amphotericin B (LAMB), die Kombination von DAMB plus FLC sowie Voriconazol (VCZ) für Patienten > 11 Jahre. Bei akuter disseminierter Candidiasis wird unverändert die Kombination von DAMB und Fluzytosin empfohlen. Zentralvenöse Katheter gelten als infektiöser Fokus und sollten wann immer möglich entfernt werden. Initialtherapie der Wahl bei vermuteten bzw. nachgewiesenen invasiven Aspergillus-Infektionen ist bei Patienten ab einem Alter von 12 Jahren VCZ. Alternativen sind DAMB und LAMB. Die Optionen für Patienten unter 12 Jahren sind im Wesentlichen auf DAMB und LAMB beschränkt. Aufgrund der bislang fehlenden Evidenz einer besseren Wirksamkeit und der noch nicht abgeschlossenen Dosisfindung von Caspofungin (CAS) sollte eine Kombinationstherapie (LAMB plus CAS bzw. VCZ plus CAS) nur bei fulminanten bzw. massiven, akut lebensbedrohlichen Infektionen erwogen werden. Bei Granulozytopenie wird die Gabe Kolonie-stimulierender Faktoren (G-CSF) empfohlen. Bei Immunsuppression sollten, wenn möglich, Glukokortikosteroide reduziert bzw. abgesetzt werden. Chirurgische Interventionen sind auf spezielle Indikationen beschränkt. Zygomykosen sind eine Indikation für hochdosiertes LAMB. Validierte Initialtherapie der Kryptokokken-Meningoenzephalitis ist die Kombination von DAMB plus Fluzytosin. Zur Behandlung der Pneumocystis jiroveci-Pneumonie wird Trimethoprim/Sulfamethoxazol bzw. Pentamidin empfohlen. Der Beitrag enthält über die genannten Entitäten hinaus eine Übersicht zur Pharmakokinetik und Dosierung antimykotischer Substanzen bei Kindern und Jugendlichen sowie detaillierte Diskussionen bzw. Empfehlungen zur empirischen antimykotischen Therapie, zur Resistenztestung, zur Diagnose und Therapie von oberflächlichen Pilzinfektionen, von invasiven Infektionen durch seltene und außereuropäische Pilzerreger und zu supportiven Therapiemaßnahmen auf der Basis der publizierten Literatur.

Abstract

Invasive fungal infections are important causes of morbidity and mortality in pediatric cancer patients with hematological malignancies and following allogeneic hematopoietic stem cell transplantation. This article provides the recommendations of the Infectious Diseases Working Party of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Hematology/Oncology (GPOH) for diagnosis and treatment of fungal infections including Pneumocystis jiroveci. They are based on specific pediatric pharmacological and regulatory considerations and on the results of clinical trials, case series and expert opinions using the evidence criteria set forth by the Infectious Diseases Society of America (IDSA). Recommendations for the most frequent clinical entities are summarized here. Options for initial therapy of uncomplicated candidemia include deoxycholate amphotericin B (DAMB), fluconazole (FLC), liposomal amphotericin B (LAMB), the combination of DAMB plus FLC as well as voriconazole (VCZ) for patients > 11 years. For acute disseminated candidiasis, the combination of DAMB plus flucytosine is recommended. Indwelling central venous catheters serve as infectious nidus and should be removed whenever feasible. First-line therapy for presumed or proven invasive Aspergillus infections in patients 12 years and older is VCZ with DAMB and LAMB serving as alternatives. Choices for patients < 12 years of age are essentially limited to DAMB and LAMB. Due to the yet lacking evidence for enhanced antifungal efficacy and the ongoing dosage finding of caspofungin (CAS) in pediatric patients, combination therapies (LAMB plus CAS or VCZ plus CAS) should only be considered for fulminant or massive, life threatening infections. In granulocytopenic patients, adjunctive therapy with colony-stimulating factors (G-CSF) is recommended. In patients under immunosuppressive therapy, glucocorticosteroids ought to be reduced or discontinued, if feasible. Surgical interventions are restricted to specific indications. Zygomyces infections are an indication for high-dose LAMB. The combination of DAMB plus flucytosine is the initial treatment of choice of cryptococcal mengoencephalitis, and for treatment of Pneumocystis jiroveci pneumonitis, trimethoprim/sulfamethoxazol or intravenous pentamidine is recommended. Beyond the listed entities, the article provides a brief review on the pharmacokinetics and dosing of antifungal agents in children and adolescents as well as detailed discussions and evidence-based recommendations for empirical antifungal therapy, diagnosis and treatment of superficial fungal infections, of invasive infections by previously rare fungal pathogens and endemic moulds and for adjunctive immunomodulatory and surgical interventions.

Schlüsselwörter

maligne Erkrankungen - Stammzelltransplantation - Mykosen - Candida - Aspergillus - Zygomyces - Cryptococcus - Pneumozystis - Diagnose - Therapie - Amphotericin - Anidulafungin - Caspofungin - Fluconazol - Fluzytosin - Itraconazol - Micafungin - Posaconazol - Ravuconazol - Voriconazol

Key words

cancer - stem cell transplantation - mycoses - candida - aspergillus - zygomyces - cryptococcus - pneumocystis - diagnosis - treatment - amphotericin - anidulafungin - caspofungin - fluconazole - flucytosine - itraconazole - micafungin - posaconazole - ravuconazole - voriconazole - children

Literatur

• 1 Abbasi S, Shenep J L, Hughes W T. et al . Aspergillosis in children with cancer: A 34-year experience.  Clin Infect Dis. 1999;  29 1210-1219
• 2 Aguilar C, Pujol I, Sala J. et al . Antifungal susceptibilities of Paecilomyces species.  Antimicrob Agents Chemother. 1998;  42 601-1604
• 3 Aliff T B, Maslak P G, Jurcic J G. et al . Refractory Aspergillus pneumonia in patients with acute leukemia: successful therapy with combination caspofungin and liposomal amphotericin.  Cancer. 2003;  97 1025-1032
• 4 Allende M, Pizzo P A. et al . Pulmonary cryptococcosis presenting as metastases in children with sarcomas.  Pediatr Infect Dis J. 1993;  12 240-243
• 5 Allo M, Miller J, Townsend T. et al . Primary cutaneous aspergillosis associated with Hickman intravenous catheters.  N Engl J Med. 1987;  315 1105-1113
• 6 Ally R, Schurmann D, Kreisel W. et al . A randomized, double-blind, double-dummy, multicenter trial of voriconazole and fluconazole in the treatment of esophageal candidiasis in immunocompromised patients.  Clin Infect Dis. 2001;  33 1447-1454
• 7 American Academy of Pediatrics .Tinea capitis. In: Peter G (ed). 1997 Red Book. Report of the Committee on Infectious Diseases. 24th edition. American Academy of Pediatrics, Elk Grove Village, IL, 1997; 523-525
• 8 Anaissie E, Bodey G P, Kantarjian H. et al . Fluconazole therapy for chronic disseminated candidiasis in patients with leukemia and prior amphotericin B therapy.  Am J Med. 1991;  91 142-150
• 9 Anaissie E, Gokaslan A, Hachem R. et al . Azole therapy for trichosporonosis: clinical evaluation of eight patients, experimental therapy for murine infection, and review.  Clin Infect Dis. 1992;  15 781-787
• 10 Anaissie E. Opportunistic mycoses in the immunocompromised host: experience at a cancer center and review.  Clin Infect Dis. 1992;  14 (Suppl 1) S43-S53
• 11 Anaissie E J, Darouiche R O, Abi-Said D. et al . Management of invasive candidal infections: results of a prospective, randomized, multicenter study of fluconazole versus amphotericin B and review of the literature.  Clin Infect Dis. 1996;  23 964-972
• 12 Anaissie E J, Hachem R, Karyotakis N C. et al . Comparative efficacies of amphotericin B, triazoles, and combination of both as experimental therapy for murine trichosporonosis.  Antimicrob Agents Chemother. 1994;  38 2541-2544
• 13 Anaissie E J, Hachem R, Legrand C. et al . Lack of activity of amphotericin B in systemic murine fusarial infection.  J Infect Dis. 1992;  165 1155-1157
• 14 Anaissie E J, Rex J H, Uzun O. et al . Predictors of adverse outcome in cancer patients with candidemia.  Am J Med. 1998;  104 238-245
• 15 Anaissie E J, Stratton S L, Dignani M C. et al . Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study and clinical implications for patients with hematologic malignancies.  Blood. 2003;  101 2542-2546
• 16 Anaissie E J, Vartivarian S E, Abi-Said D. et al . Fluconazole versus amphotericin B in the treatment of hematogenous candidiasis: a matched cohort study.  Am J Med. 1996;  101 170-176
• 17 Andes D, Ogtrop M van. Characterization and quantitation of the pharmacodynamics of fluconazole in a neutropenic murine disseminated candidiasis infection model.  Antimicrob Agents Chemother. 1999;  43 2116-2120
• 18 Arathoon E G, Gotuzzo E, Noriega L M. et al . Randomized, double-blind, multicenter study of caspofungin versus amphotericin B for treatment of oropharyngeal and esophageal candidiases.  Antimicrob Agents Chemother. 2002;  46 451-457
• 19 Arnow P M, Houchins S G, Pugliese G. An outbreak of tinea corporis in hospital personnel caused by a patient with Trichophyton tonsurans infection.  Pediatr Infect Dis J. 1991;  10 355-359
• 20 Ascioglu S, Rex J H, de Pauw B. et al., Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer; Mycoses Study Group of the National Institute of Allergy and Infectious Diseases . Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus.  Clin Infect Dis. 2002;  34 7-14
• 21 Aucott J N, Fayen J, Grossnicklas H, Morrissey A. et al . Invasive infection with Saccharomyces cerevisiae: report of three cases and review.  Rev Infect Dis. 1990;  12 406-411
• 22 Baley J E, Meyers C, Kliegman R M. et al . Pharmacokinetics, outcome of treatment, and toxic effects of amphotericin B and 5-fluorocytosine in neonates.  J Pediatr. 1990;  116 791-797
• 23 Barber G R, Brown A E, Kiehn T E. et al . Catheter-related Malassezia furfur fungemia in immunocompromised patients.  Am J Med. 1993;  95 365-370
• 24 Beck J M, Harmsen A G. Lymphocytes in host defense against Pneumocystis carinii.  Semin Respir Infect. 1998;  13 330-338
• 25 Bennett J E, Dismukes W E, Duma R J. et al . A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptococcal meningitis.  N Engl J Med. 1979;  301 126-131
• 26 Bennett J E, Powers J, Walsh T. et al . Forum report: issues in clinical trials of empirical antifungal therapy in treating febrile neutropenic patients.  Clin Infect Dis. 2003;  36 (Suppl 3) S117-S122
• 27 Benson J M, Nahata M C. Pharmacokinetics of amphotericin B in children.  Antimicrob Agents Chemother. 1989;  33 1989-1993
• 28 Berenguer J, Allende M C, Lee J W. et al . Pathogenesis of pulmonary aspergillosis. Granulocytopenia versus cyclosporine and methylprednisolone-induced immunosuppression.  Am J Respir Crit Care Med. 1995;  152 1079-1086
• 29 Berenguer J, Buck M, Witebsky F. et al . Lysis-centrifugation blood cultures in the detection of tissue-proven invasive candidiasis. Disseminated versus single-organ infection.  Diagn Microbiol Infect Dis. 1993;  17 103-109
• 30 Berenguer J, Rodriguez-Tudela J L. et al., Scedosporium Prolificans Spanish Study Group . Deep infections caused by Scedosporium prolificans. A report on 16 cases in Spain and a review of the literature.  Medicine (Baltimore). 1997;  76 256-265
• 31 Besnard M, Hartmann O, Valteau-Couanet D. et al . Systemic Candida infection in pediatric BM autotransplantation: clinical signs, outcome and prognosis.  Bone Marrow Transplant. 1993;  11 465-470
• 32 Bjerke J W, Meyers J D, Bowden R A. Hepatosplenic candidiasis - a contraindication to marrow transplantation?.  Blood. 1994;  84 2811-2814
• 33 Bodey G P. Fungal infections complicating acute leukemia.  J Chronic Dis. 1966;  19 667-687
• 34 Bodey G P. The emergence of fungi as major hospital pathogens.  J Hosp Infect. 1988;  11 (Suppl A) S411-S426
• 35 Bohme A, Ruhnke M, Buchheidt D. et al., Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) . Treatment of fungal infections in hematology and oncology - guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO).  Ann Hematol. 2003;  82 (Suppl 2) S133-S140
• 36 Boogaerts M, Winston D J, Bow E J. et al., Itraconazole Neutropenia Study Group . Intravenous and oral itraconazole versus intravenous amphotericin B deoxycholate as empirical antifungal therapy for persistent fever in neutropenic patients with cancer who are receiving broad-spectrum antibacterial therapy. A randomized, controlled trial.  Ann Intern Med. 2001;  135 412-422
• 37 Boogaerts M A, Maertens J, Der Geest R van. et al . Pharmacokinetics and safety of a 7-day administration of intravenous itraconazole followed by a 14-day administration of itraconazole oral solution in patients with hematologic malignancy.  Antimicrob Agents Chemother. 2001;  45 981-985
• 38 Boucher H W, Groll A H, Chiou C C. et al . Newer systemic antifungal agents: pharmacokinetics, safety and efficacy.  Drugs. 2004;  64 1997-2020
• 39 Bozzette S A, Sattler F R, Chiu J. et al., California Collaborative Treatment Group . A controlled trial of early adjunctive treatment with corticosteroids for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.  N Engl J Med. 1990;  323 1451-1457
• 40 Brammer K W, Coates P E. Pharmacokinetics of fluconazole in pediatric patients.  Eur J Clin Microbiol Infect Dis. 1994;  13 325-329
• 41 Brandt M E, Warnock D W. Epidemiology, clinical manifestations, and therapy of infections caused by dematiaceous fungi.  J Chemother. 2003;  15 (Suppl 2) S36-S47
• 42 Braun D K, Kauffman C A. Rhodotorula fungaemia: a life-threatening complication of indwelling central venous catheters.  Mycoses. 1992;  35 305-308
• 43 Brouwer A E, Rajanuwong A, Chierakul W. et al . Combination antifungal therapies for HIV-associated cryptococcal meningitis: a randomised trial.  Lancet. 2004;  363 1764-1767
• 44 Browne M J, Hubbard S M, Longo D L. et al . Excess prevalence of Pneumocystis carinii pneumonia in patients treated for lymphoma with combination chemotherapy.  Ann Intern Med. 1986;  104 338-344
• 45 Buchheidt D, Baust C, Skladny H. et al . Detection of Aspergillus species in blood and bronchoalveolar lavage samples from immunocompromised patients by means of 2-step polymerase chain reaction: clinical results.  Clin Infect Dis. 2001;  33 428-435
• 46 Butugan O, Sanchez T G, Goncalez F. et al . Rhinocerebral mucormycosis: predisposing factors, diagnosis, therapy, complications and survival.  Rev Laryngol Otol Rhinol (Bord). 1996;  117 53-55
• 47 Byrd J C, Hargis J B, Kester K E. et al . Opportunistic pulmonary infections with fludarabine in previously treated patients with low-grade lymphoid malignancies: a role for Pneumocystis carinii pneumonia prophylaxis.  Am J Hematol. 1995;  48 135-142
• 48 Caillot D, Bassaris H, McGeer A. et al . Intravenous itraconazole followed by oral itraconazole in the treatment of invasive pulmonary aspergillosis in patients with hematologic malignancies, chronic granulomatous disease, or AIDS.  Clin Infect Dis. 2001;  338 83-90
• 49 Caillot D, Casasnovas O, Bernard A. et al . Improved management of invasive pulmonary aspergillosis in neutropenic patients using early thoracic computed tomographic scan and surgery.  J Clin Oncol. 1997;  15 139-147
• 50 Caillot D, Couaillier J F, Bernard A. et al . Increasing volume and changing characteristics of invasive pulmonary aspergillosis on sequential thoracic computed tomography scans in patients with neutropenia.  J Clin Oncol. 2001;  19 253-259
• 51 Calandra T, Bille J, Schneider R. et al . Clinical significance of Candida isolated from peritoneum in surgical patients.  Lancet. 1989;  2 1437-1440
• 52 Centers for Disease Control and Prevention . Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients.  MMWR Morb Mortal Wkly Rep. 2000;  49 (RR-10) 1-95
• 53 Chapman S W, Bradsher R W, Campbell G D. et al., Infectious Diseases Society of America . Practice guidelines for the management of patients with blastomycosis.  Clin Infect Dis. 2000;  30 679-683
• 54 Chapman S W, Pappas P, Kauffmann C. et al . Comparative evaluation of the efficacy and safety of two doses of terbinafine (500 and 1 000 mg day-1) in the treatment of cutaneous or lymphocutaneous sporotrichosis.  Mycoses. 2004;  47 62-68
• 55 Cornely O A, Hiddemann W, Link H. et al . Interventional antimicrobial therapy in febrile neutropenic patients - Paul Ehrlich Society for Chemotherapy (PEG) Study II.  Ann Hematol. 1997;  74 (Suppl I) A51
• 56 Cyklis R, Zielinska A. Pneumocystis carinii infection in children with acute leukemia and non-Hodgkin malignant lymphoma.  Pediatr Pol. 1983;  58 337-340
• 57 Dannaoui E, Meis J F, Loebenberg D. et al . Activity of posaconazole in treatment of experimental disseminated zygomycosis.  Antimicrob Agents Chemother. 2003;  47 3647-3650
• 58 de Repentigny L, Ratelle J, Leclerc J M. et al . Repeated-dose pharmacokinetics of an oral solution of itraconazole in infants and children.  Antimicrob Agents Chemother. 1998;  42 404-408
• 59 del Palacio A, Delgado Vicente S, Menendez Ramos F. et al . Randomized comparative clinical trial of itraconazole and selenium sulfide shampoo for the treatment of pityriasis versicolor.  Rev Infect Dis. 1987;  9 (Suppl 1) S121-S127
• 60 Denning D W, Marinus A, Cohen J. et al., EORTC Invasive Fungal Infections Cooperative Group . An EORTC multicentre prospective survey of invasive aspergillosis in haemato-logical patients: diagnosis and therapeutic outcome.  J Infect. 1998;  37 173-180
• 61 Denning D W, Ribaud P, Milpied N. et al . Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis.  Clin Infect Dis. 2002;  34 563-571
• 62 Denning D W, Stevens D A. Antifungal and surgical treatment of invasive aspergillosis: review of 2 121 published cases.  Rev Infect Dis. 1990;  12 1147-1201
• 63 Denning D W, Tucker R M, Hanson L H. et al . Treatment of invasive aspergillosis with itraconazole.  Am J Med. 1989;  86 791-800
• 64 Denning D W. Aspergillus tracheobronchitis.  Clin Infect Dis. 1994;  19 1176-1177
• 65 Denning D W. Invasive aspergillosis.  Clin Infect Dis. 1998;  26 781-805
• 66 DeVita V T, Goodell B, Hubbard S. et al . Pneumocystis pneumonia in patients with cancer: clinical setting.  Natl Cancer Inst Monogr. 1976;  43 41-47
• 67 Dewsnup D H, Stevens D A. Efficacy of oral amphotericin B in AIDS patients with thrush clinically resistant to fluconazole.  J Med Vet Mycol. 1994;  32 389-393
• 68 Diamond R D. Invasive aspergillosis: host defenses.  Recent Results Cancer Res. 1993;  132 109-115
• 69 Dohn M N, Weinberg W G, Torres R A. et al., Atovaquone Study Group . Oral atovaquone compared with intravenous pentamidine for Pneumocystis carinii pneumonia in patients with AIDS.  Ann Intern Med. 1994;  121 174-180
• 70 Duong T A. Infection due to Penicillium marneffei, an emerging pathogen: review of 155 reported cases.  Clin Infect Dis. 1996;  23 125-130
• 71 Edman J C, Kovacs J A, Masur H. et al . Ribosomal RNA sequence shows Pneumocystis carinii to be a member of the fungi.  Nature. 1988;  334 519-522
• 72 Eggimann P, Francioli P, Bille J. et al . Fluconazole prophylaxis prevents intra-abdominal candidiasis in high-risk surgical patients.  Crit Care Med. 1999;  27 1066-1072
• 73 Eichel M, Just-Nubling G, Helm E B. et al . [Itraconazole suspension in the treatment of HIV-infected patients with fluconazole-resistant oropharyngeal candidiasis and esophagitis].  Mycoses. 1996;  39 (Suppl 1) S102-S106
• 74 Einsele H, Hebart H, Roller G. et al . Detection and identification of fungal pathogens in blood by using molecular probes.  J Clin Microbiol. 1997;  35 1353-1360
• 75 Endophthalmitis Vitrectomy Study Group . Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis.  Arch Ophthalmol. 1995;  113 1479-1496
• 76 EORTC International Antimicrobial Therapy Cooperative Group . Empiric antifungal therapy in febrile granulocytopenic patients.  Am J Med. 1989;  86 668-672
• 77 Erer B, Galimberti M, Lucarelli G. et al . Trichosporon beigelii: a life-threatening pathogen in immunocompromised hosts.  Bone Marrow Transplant. 2000;  25 745-749
• 78 Espinel-Ingroff A. Comparison of In vitro activities of the new triazole SCH56592 and the echinocandins MK-0991 (L-743,872) and LY303366 against opportunistic filamentous and dimorphic fungi and yeasts.  J Clin Microbiol. 1998;  36 2950-2956
• 79 Fisher J F, Newman C L, Sobel J D. Yeast in the urine: solutions for a budding problem.  Clin Infect Dis. 1995;  20 183-189
• 80 Fleece D, Gaughan J P, Aronoff S C. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials.  Pediatrics. 2004;  114 1312-1315
• 81 Flynn P M, Cunningham C K, Kerkering T. et al., The Multicenter Fluconazole Study Group . Oropharyngeal candidiasis in immunocompromised children: a randomized, multicenter study of orally administered fluconazole suspension versus nystatin.  J Pediatr. 1995;  127 322-328
• 82 Foot A, Veys P, Gibson B. Itraconazole oral solution as antifungal prophylaxis in children undergoing stem cell transplantation or intensive chemotherapy for haematological disorders.  Bone Marrow Transplant. 1999;  24 1089-1093
• 83 Fothergill A W. Identification of dematiaceous fungi and their role in human disease.  Clin Infect Dis. 1996;  22 (Suppl 2) S179-S184
• 84 Fournier S, Pavageau W, Feuillhade M. et al . Use of voriconazole to successfully treat disseminated Trichosporon asahii infection in a patient with acute myeloid leukaemia.  Eur J Clin Microbiol Infect Dis. 2002;  21 892-896
• 85 Francis P, Walsh T J. Evolving role of flucytosine in immunocompromised patients: new insights into safety, pharmacokinetics, and antifungal therapy.  Clin Infect Dis. 1992;  15 1003-1018
• 86 Franklin J A, McCormick J, Flynn P M. Retrospective study of the safety of caspofungin in immunocompromised pediatric patients.  Pediatr Infect Dis J. 2003;  22 747-749
• 87 Friedlander S F, Suarez S. Pediatric antifungal therapy.  Dermatol Clin. 1998;  16 527-537
• 88 Galgiani J N, Ampel N M, Catanzaro A. et al., Infectious Diseases Society of America . Practice guideline for the treatment of coccidioidomycosis.  Clin Infect Dis. 2000;  30 658-661
• 89 Galgiani J N, Catanzaro A, Cloud G A. et al., A randomized, double-blind trial. Mycoses Study Group . Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis.  Ann Intern Med. 2000;  133 676-686
• 90 Glasmacher A, Prentice A, Gorschluter M. et al . Itraconazole prevents invasive fungal infections in neutropenic patients treated for hematologic malignancies: evidence from a meta-analysis of 3 597 patients.  J Clin Oncol. 2003;  21 4615-4626
• 91 Goldie S J, Kiernan-Tridle L, Torres C. et al . Fungal peritonitis in a large chronic peritoneal dialysis population: a report of 55 episodes.  Am J Kidney Dis. 1996;  28 86-91
• 92 Gonzalez C E, Rinaldi M G, Sugar A M. Zygomycosis.  Infect Dis Clin North Am. 2002;  16 895-914
• 93 Goodman J L, Winston D J, Greenfield R A. et al . A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation.  N Engl J Med. 1992;  326 845-851
• 94 Goodrich J M, Reed E C, Mori M. et al . Clinical features and analysis of risk factors for invasive Candidal infection after marrow transplantation.  J Infect Dis. 1991;  164 731-740
• 95 Gottlieb G S, Lesser C F, Holmes K K. et al . Disseminated sporotrichosis associated with treatment with immunosuppressants and tumor necrosis factor-alpha antagonists.  Clin Infect Dis. 2003;  37 838-840
• 96 Graybill J R, Sobel J, Saag M. et al., The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups . Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis.  Clin Infect Dis. 2000;  30 47-54
• 97 Graybill J R, Vazquez J, Darouiche R O. et al . Randomized trial of itraconazole oral solution for oropharyngeal candidiasis in HIV/AIDS patients.  Am J Med. 1998;  104 33-39
• 98 Greenberg R N, Anstead G, Herbrecht R. et al .Posaconazole experience in the treatment of zygomycosis. In: Abstracts of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, DC 2003; abstract M-1757: 476
• 99 Groll A, Renz S, Gerein V. et al . Fatal haemoptysis associated with invasive pulmonary aspergillosis treated with high-dose amphotericin B and granulocyte-macrophage colony-stimulating factor (GM-CSF).  Mycoses. 1992;  35 67-75
• 100 Groll A H, Gea-Banacloche J C, Glasmacher A. et al . Clinical pharmacology of antifungal compounds.  Infect Dis Clin North Am. 2003;  17 159-191
• 101 Groll A H, Giri N, Petraitis V. et al . Comparative efficacy and distribution of lipid formulations of amphotericin B in experimental Candida albicans infection of the central nervous system.  J Infect Dis. 2000;  182 274-282
• 102 Groll A H, Just-Nuebling G, Kurz M. et al . Fluconazole versus nystatin in the prevention of Candida infections in children and adolescents undergoing remission induction or consolidation chemotherapy for cancer.  J Antimicrob Chemother. 1997;  40 855-862
• 103 Groll A H, Keul H G, Brodt R. et al . AIDS-associated atypical Pneumocystis carinii pneumonia revisited.  Clin Infect Dis. 1998;  26 1005-1006
• 104 Groll A H, Kolve H. Antifungal agents: in vitro susceptibility testing, pharmacodynamics, and prospects for combination therapy.  Eur J Clin Microbiol Infect Dis. 2004;  23 256-270
• 105 Groll A H, Kurz M, Schneider W. et al . Five-year survey of invasive aspergillosis in a pediatric cancer center: Incidence, clinical presentation, management, and long-term survival.  Mycoses. 1999;  42 431-442
• 106 Groll A H, Lehrnbecher T. New antifungal drugs and the pediatric cancer patient: current status of clinical development.  Klin Paed. 2005;  217 158-168
• 107 Groll A H, Muller F M, Piscitelli S C. et al . Lipid formulations of amphotericin B: clinical perspectives for the management of invasive fungal infections in children with cancer.  Klin Padiatr. 1998;  210 264-273
• 108 Groll A H, Piscitelli S C, Walsh T J. Antifungal pharmacodynamics: concentration-effect relationships in vitro and in vivo.  Pharmacotherapy. 2001;  21 133S-148S
• 109 Groll A H, Piscitelli S C, Walsh T J. Clinical pharmacology of systemic antifungal agents: a comprehensive review of agents in clinical use, current investigational compounds, and putative targets for antifungal drug development.  Adv Pharmacol. 1998;  44 343-500
• 110 Groll A H, Ritter J, Muller F M. Guidelines for prevention of Pneumocystis carinii pneumonitis in children and adolescents with cancer.  Klin Padiatr. 2001;  213 (Suppl 1) A38-A49
• 111 Groll A H, Sehrt P, Ahrens P. et al . Differenzialdiagnose pulmonaler Infektionen bei Kindern und Jugendlichen mit neoplastischen Erkrankungen.  Monatschr Kinderheilkunde. 1997;  145 1197-1207
• 112 Groll A H, Shah P M, Mentzel C. et al . Trends in the postmortem epidemiology of invasive fungal infections at a university hospital.  J Infect. 1996;  33 23-32
• 113 Groll A H, Walsh T J. Antifungal Agents. In Feigin, Cherry, Demmler and Kaplan (eds). Textbook of Pediatric Infectious Diseases. 5th edition. Harcourt Health Sciences, Philadelphia 2003; 3075-3108
• 114 Groll A H, Walsh T J. Antifungal chemotherapy: advances and perspectives.  Swiss Med Wkly. 2002;  132 303-311
• 115 Groll A H, Walsh T J. Uncommon opportunistic fungi: new nosocomial threats.  Clin Microbiol Infect. 2001;  7 (Suppl 2) 8-24
• 116 Groll A H, Wood L, Roden M. et al . Safety, pharmacokinetics, and pharmacodynamics of cyclodextrin itraconazole in pediatric patients with oropharyngeal candidiasis.  Antimicrob Agents Chemother. 2002;  46 2554-2563
• 117 Grossman M E, Pappert A S, Garzon M C. et al . Invasive Trichophyton rubrum infection in the immunocompromised host: report of three cases.  J Am Acad Dermatol. 1995;  33 315-318
• 118 Grossmann M E, Fithian E C, Behrens C. et al . Primary cutaneous aspergillosis in six leukemic children.  J Am Acad Dermatol. 1985;  12 313-318
• 119 Guarro J, Gams W, Pujol I. et al . Acremonium species: new emerging fungal opportunists - in vitro antifungal susceptibilities and review.  Clin Infect Dis. 1997;  25 1222-1229
• 120 Guiot H F, Fibbe W E, 't Wout J W van. Risk factors for fungal infection in pa-tients with malignant hematologic disorders: implications for empirical therapy and prophylaxis.  Clin Infect Dis. 1994;  18 525-532
• 121 Gupta A K, Dlova N, Taborda P. et al . Once weekly fluconazole is effective in children in the treatment of tinea capitis: a prospective, multicentre study.  Br J Dermatol. 2000;  142 965-968
• 122 Haron E, Anaissie E, Dumphy F. et al . Hansenula anomala fungemia.  Rev Infect Dis. 1988;  10 1182-1186
• 123 Haron E, Vartivarian S, Anaissie E. et al . Primary Candida pneumonia. Experience at a large cancer center and review of the literature.  Medicine (Baltimore). 1993;  72 137-142
• 124 Hazen K C. New and emerging yeast pathogens.  Clin Microbiol Rev. 1995;  8 462-478
• 125 Hebart H, Loffler J, Meisner C. et al . Early detection of aspergillus infection after allogeneic stem cell transplantation by polymerase chain reaction screening.  J Infect Dis. 2000;  181 1713-1719
• 126 Hegener P, Troke P F, Fatkenheuer G. et al . Treatment of fluconazole-resistant candidiasis with voriconazole in patients with AIDS.  AIDS. 1998;  12 2227-2228
• 127 Herbrecht R, Denning D W, Patterson T F. et al., Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group . Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis.  N Engl J Med. 2002;  347 408-415
• 128 Herbrecht R, Letscher-Bru V, Bowden R A. et al . Treatment of 21 cases of invasive mucormycosis with amphotericin B colloidal dispersion.  Eur J Clin Microbiol Infect Dis. 2001;  20 460-466
• 129 Hopewell P C. Pneumocystis carinii pneumonia: diagnosis.  J Infect Dis. 1988;  157 1115-1119
• 130 Howard R M, Frieden I J. Dermatophyte infections in children.  Adv Pediatr Infect Dis. 1999;  14 73-107
• 131 Howden B P, Slavin M A, Schwarer A P. et al . Successful control of disseminated Scedosporium prolificans infection with a combination of voriconazole and terbinafine.  Eur J Clin Microbiol Infect Dis. 2003;  22 111-113
• 132 Hubel K, Carter R A, Liles W C. et al . Granulocyte transfusion therapy for infections in candidates and recipients of HPC transplantation: a comparative analysis of feasibility and outcome for community donors versus related donors.  Transfusion. 2002;  42 1414-1421
• 133 Hughes W T, Feldman S, Aur R J. et al . Intensity of immunosuppressive therapy and the incidence of Pneumocystis carinii pneumonitis.  Cancer. 1975;  36 2004-2009
• 134 Hughes W T, Feldman S, Chaudhary S C. et al . Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia.  J Pediatr. 1978;  92 285-291
• 135 Hughes W T, Kuhn S, Chaudhary S. et al . Successful chemoprophylaxis for Pneumocystis carinii pneumonitis.  N Engl J Med. 1977;  297 1419-1426
• 136 Hughes W T, Price R A, Kim H K. et al . Pneumocystis carinii pneumonitis in children with malignancies.  J Pediatr. 1973;  82 404-415
• 137 Hughes W T, Rivera G K, Schell M J. et al . Successful intermittent chemoprophylaxis for Pneumocystis carinii pneumonitis.  N Engl J Med. 1987;  316 1627-1632
• 138 Hughes W T. Current issues in the epidemiology, transmission, and reactivation of Pneumocystis carinii.  Semin Respir Infect. 1998;  13 283-288
• 139 Humbert H, Cabiac M D, Denouel J. et al . Pharmacokinetics of terbinafine and of its five main metabolites in plasma and urine, following a single oral dose in healthy subjects.  Biopharm Drug Dispos. 1995;  16 685-694
• 140 Humbert H, Denouel J, Cabiac M D. et al . Pharmacokinetics of terbinafine and five known metabolites in children, after oral administration.  Biopharm Drug Dispos. 1998;  19 417-423
• 141 Ibrahim A S, Avanessian V, Spellberg B. et al . Liposomal amphotericin B, and not amphotericin B deoxycholate, improves survival of diabetic mice infected with Rhizopus oryzae.  Antimicrob Agents Chemother. 2003;  47 3343-3344
• 142 Jahangir M, Hussain I, Ul Hasan M. et al . A double-blind, randomized, comparative trial of itraconazole versus terbinafine for 2 weeks in tinea capitis.  Br J Dermatol. 1998;  139 672-674
• 143 Johnson E M, Szekely A, Warnock D W. In-vitro activity of voriconazole, itraconazole and amphotericin B against filamentous fungi.  J Antimicrob Chemother. 1998;  42 741-745
• 144 Johnson L B, Bradley S F, Kauffman C A. Fungaemia due to Cryptococcus laurentii and a review of non-neoformans cryptococcaemia.  Mycoses. 1998;  41 277-280
• 145 Johnson L B, Kauffman C A. Voriconazole: a new triazole antifungal agent.  Clin Infect Dis. 2003;  36 630-637
• 146 Johnson P C, Wheat L J, Cloud G A, Powderly W G, Hafner R, Kauffman C A, Dismukes W E. et al., U.S. National Institute of Allergy and Infectious Diseases Mycoses Study Group . Safety and efficacy of liposomal amphotericin B compared with conventional amphotericin B for induction therapy of histoplasmosis in patients with AIDS.  Ann Intern Med. 2002;  137 105-109
• 147 Jones T C. Overview of the use of terbinafine (Lamisil) in children.  Br J Dermatol. 1995;  132 683-689
• 148 Juster-Reicher A, Leibovitz E, Linder N. et al . Liposomal amphotericin B (AmBisome) in the treatment of neonatal candidiasis in very low birth weight infants.  Infection. 2000;  28 223-226
• 149 Kartsonis N, DiNubile M J, Bartizal K. et al . Efficacy of caspofungin in the treatment of esophageal candidiasis resistant to fluconazole.  J Acquir Immune Defic Syndr. 2002;  31 183-187
• 150 Kauffman C A, Bradley S F, Ross S C. et al . Hepatosplenic candidiasis: successful treatment with fluconazole.  Am J Med. 1991;  91 137-141
• 151 Kauffman C A, Hajjeh R, Chapman S W. Practice guidelines for the management of patients with sporotrichosis. For the Mycoses Study Group. Infectious Diseases Society of America.  Clin Infect Dis. 2000;  30 684-687
• 152 Kauffman C A, Vazquez J A, Sobel J D. et al., The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group . Prospective multicenter surveillance study of funguria in hospitalized patients.  Clin Infect Dis. 2000;  30 14-18
• 153 Kearns G L, Reed M D. Clinical pharmacokinetics in infants and children, a reappraisal.  Clin Pharmacokinetics. 1989;  17 (Suppl 1) S29-S67
• 154 Kiehn T E, Gorey E, Brown A E. et al . Sepsis due to Rhodotorula related to use of indwelling central venous catheters.  Clin Infect Dis. 1992;  14 841-846
• 155 King D, Cheever L W, Hood A. et al . Primary invasive cutaneous Microsporum canis infections in immunocompromised patients.  J Clin Microbiol. 1996;  34 460-462
• 156 Kirkpatrick C H. Chronic mucocutaneous candidiasis.  Pediatr Infect Dis J. 2001;  20 197-206
• 157 Klein N C, Duncanson F P, Lenox T H. et al . Trimethoprim-sulfamethoxazole versus pentamidine for Pneumocystis carinii pneumonia in AIDS patients: results of a large prospective randomized treatment trial.  AIDS. 1992;  6 301-305
• 158 Klingspor L, Stintzing G, Fasth A. et al . Deep Candida infection in children receiving allogeneic bone marrow transplants: incidence, risk factors and diagnosis.  Bone Marrow Transplant. 1996;  17 1043-1048
• 159 Klingspor L, Stintzing G, Tollemar J. Deep Candida infection in children with leukaemia: clinical presentations, diagnosis and outcome.  Acta Paediatr. 1997;  86 30-36
• 160 Kolve H, Lehrnbecher T, Ehlert K. et al . Safety, tolerance and plasma concentrations of voriconazole in immunocompromised pediatric patients (abstract).  Clin Microbiol Infect. 2004;  10 (Suppl 3) S40-S41
• 161 Kontoyiannis D P, Hachem R, Lewis R E. et al . Efficacy and toxicity of caspofungin in combination with liposomal amphotericin B as primary or salvage treatment of invasive aspergillosis in patients with hematologic malignancies.  Cancer. 2003;  98 292-299
• 162 Kontoyiannis D P, Wessel V C, Bodey G P. et al . Zygomycosis in the 1990s in a tertiary-care cancer center.  Clin Infect Dis. 2000;  30 851-856
• 163 Koren G, Lau A, Klein J. et al . Pharmacokinetics and adverse effects of amphotericin B in infants and children.  J Pediatr. 1988;  113 559-563
• 164 Kovacs J A, Gill V J, Meshnick S. et al . New insights into transmission, diagnosis, and drug treatment of Pneumocystis carinii pneumonia.  JAMA. 2001;  286 2450-2460
• 165 Kovacs J A, Hiemenz J W, Macher A M. et al . Pneumocystis carinii pneumonia: a comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies.  Ann Intern Med. 1984;  100 663-671
• 166 Kovacs J A, Ng V L, Masur H, Leoung G. et al . Diagnosis of Pneumocystis carinii pneumonia: improved detection in sputum with use of monoclonal antibodies.  N Engl J Med. 1988;  318 589-593
• 167 Krcmery V, Krupova I, Denning D W. Invasive yeast infections other than Candida spp. in acute leukaemia.  J Hosp Infect. 1999;  41 181-194
• 168 Krzeska I, Yeates R A, Pfaff G. Single dose intravenous pharmacokinetics of fluconazole in infants.  Drugs Exp Clin Res. 1993;  19 267-271
• 169 Kuhlman J E, Fishman E K, Siegelman S S. Invasive pulmonary aspergillosis in acute leukemia: characteristic findings on CT, the CT halo sign, and the role of CT in early diagnosis.  Radiology. 1985;  157 611-614
• 170 Kullberg B J, Pappas P, Ruhnke M. et al . Voriconazole compared with a strategy of amphotericin B followed by fluconazole for treatment of candidemia in nonneutropenic patients (abstract).  Clin Microbiol Infect. 2004;  10 (Suppl 3) S41
• 171 Lake D E, Kunzweiler J, Beer M. et al . Fluconazole versus amphotericin B in the treatment of esophageal candidiasis in cancer patients.  Chemotherapy. 1996;  42 308-314
• 172 Larkin J A, Montero J A. Efficacy and safety of amphotericin B lipid complex for zygomycosis.  Infect Med. 2003;  20 201-206
• 173 Larsen H H, Masur H, Kovacs J A. et al . Development and evaluation of a quantitative, touch-down, real-time PCR assay for diagnosing Pneumocystis carinii pneumonia.  J Clin Microbiol. 2002;  40 490-494
• 174 Larsen R A, Bozzette S A, Jones B E. et al . Fluconazole combined with flucytosine for treatment of cryptococcal meningitis in patients with AIDS.  Clin Infect Dis. 1994;  19 741-745
• 175 Lascari A D, Pearce J M, Swanson H. Sudden death due to disseminated cryptococcosis in a child with leukemia in remission.  South Med J. 1997;  90 1253-1254
• 176 Lee J W, Seibel N L, Amantea M. et al . Safety, tolerance, and pharmacokinetics of fluconazole in children with neoplastic diseases.  J Pediatr. 1992;  120 987-993
• 177 Leenders A C, Reiss P, Portegies P. et al . Liposomal amphotericin B (AmBisome) compared with amphotericin B both followed by oral fluconazole in the treatment of AIDS-associated cryptococcal meningitis.  AIDS. 1997;  11 1463-1471
• 178 Leggiadro R J, Barrett F F, Hughes W T. Extrapulmonary cryptococcosis in immunocompromised infants and children.  Pediatr Infect Dis J. 1992;  11 43-47
• 179 Lehrnbecher T, Attarbaschi A, Schuster F. et al .Caspofungin in immunocompromised pediatric patients without therapeutic alternative: a multicenter survey. Abstracts of the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy; American Society for Microbiology, Washington, DC 2004; abstr. M-1019: 414
• 180 Lehrnbecher T. Hematopoietic growth factors in prophylaxis and therapy of infections complications in children with neutropenia.  Klin Padiatr. 2001;  213 212-238
• 181 Levine J, Bernard D B, Idelson B A. et al . Fungal peritonitis complicating continuous ambulatory peritoneal dialysis: successful treatment with fluconazole, a new orally active antifungal agent.  Am J Med. 1989;  86 825-827
• 182 Lewis S M, Lewis B G. Nosocomial transmission of Trichophyton tonsurans tinea corporis in a rehabilitation hospital.  Infect Control Hosp Epidemiol. 1997;  18 322-325
• 183 Limper A H, Hoyte J S, Standing J E. The role of alveolar macrophages in Pneumocystis carinii degradation and clearance from the lung.  J Clin Invest. 1997;  99 2110-2117
• 184 Lopez-Gomez S, Del Palacio A, Cutsem J Van. et al . Itraconazole versus griseofulvin in the treatment of tinea capitis: a double-blind randomized study in children.  Int J Dermatol. 1994;  33 743-747
• 185 Lortholary O, Mouas-Dupuy M, Dupont B. et al .Voriconazole for bone aspergillosis: a worldwide experience of 19 cases. In Abstracts of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Chemotherapy: Washington, DC 2003; abstr. M-979: 450
• 186 Louie A, Drusano G L, Banerjee P. et al . Pharmacodynamics of fluconazole in a murine model of systemic candidiasis.  Antimicrob Agents Chemother. 1998;  42 1105-1109
• 187 MacDonald L, Baker C, Chenoweth C. Risk factors for candidemia in a children's hospital.  Clin Infect Dis. 1998;  26 642-645
• 188 Maertens J, Glasmacher A, Herbrecht R. et al .Multicenter noncomparative study of caspofungin combined with other antifungals in adults with invasive aspergillosis refractory or intolerant to standard regimens. In: Abstract Addendum (Late-Breaker) of the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Chemotherapy: Washington, DC 2004; abstr. M-671 a: 14
• 189 Maertens J, Lagrou K, Deweerdt H. et al . Disseminated infection by Scedosporium prolificans: an emerging fatality among haematology patients. Case report and review.  Ann Hematol. 2000;  79 340-344
• 190 Maertens J, Raad I, Petrikkos G. et al., Caspofungin Salvage Aspergillosis Study Group . Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy.  Clin Infect Dis. 2004;  39 1563-1571
• 191 Maertens J, Eldere J Van, Verhaegen J. et al . Use of circulating galactomannan screening for early diagnosis of invasive aspergillosis in allogeneic stem cell transplant recipients.  J Infect Dis. 2002;  186 1297-1306
• 192 Maertens J, Verhaegen J, Demuynck H. et al . Autopsy-controlled prospective evaluation of serial screening for circulating galactomannan by a sandwich enzyme-linked immunosorbent assay for hematological patients at risk for invasive Aspergillosis.  J Clin Microbiol. 1999;  37 3223-3228
• 193 Maertens J, Verhaegen J, Lagrou K. et al . Screening for circulating galactomannan as a noninvasive diagnostic tool for invasive aspergillosis in prolonged neutropenic patients and stem cell transplantation recipients: a prospective validation.  Blood. 2001;  97 1604-1611
• 194 Maksymiuk A W, Thongprasert S, Hopfer R. et al . Systemic candidiasis in cancer patients.  Am J Med. 1984;  77 20-27
• 195 Marina N M, Flynn P M, Rivera G K. et al . Candida tropicalis and Candida albicans fungemia in children with leukemia.  Cancer. 1991;  68 594-599
• 196 Marr K A, Boeckh M, Carter R A. et al . Combination antifungal therapy for invasive aspergillosis.  Clin Infect Dis. 2004;  39 797-802
• 197 Marr K A, Carter R A, Crippa F. et al . Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients.  Clin Infect Dis. 2002;  34 909-917
• 198 Martin C A, Roberts S, Greenberg R N. Voriconazole treatment of disseminated Paecilomyces infection in a patient with acquired immunodeficiency syndrome.  Clin Infect Dis. 2002;  35 e78-e81
• 199 Martinez-Vazquez C, Fernandez-Ulloa J, Bordon J. et al . Candida albicans endophthalmitis in brown heroin addicts: response to early vitrectomy preceded and followed by antifungal therapy.  Clin Infect Dis. 1998;  27 1130-1133
• 200 Martino P, Gastaldi R, Raccah R. et al . Clinical patterns of Fusarium infections in immunocompromised patients.  J Infect. 1994;  28 (Suppl 1) 7-15
• 201 Martino R, Lopez R, Sureda A. et al . Risk of reactivation of a recent invasive fungal infection in patients with hematological malignancies undergoing further intensive chemo-radiotherapy. A single-center experience and review of the literature.  Haematologica. 1997;  82 297-304
• 202 Martino R, Salavert M, Parody R. et al . Blastoschizomyces capitatus infection in patients with leukemia: report of 26 cases.  Clin Infect Dis. 2004;  38 335-341
• 203 Masur H. Respiratory disease in the immunocompromised host. In: Shelhamer J, Pizzo PA, Paillo JE, Masur H (eds). Pneumocystis carinii Pneumonia. Lippincott, Philadelphia 1991; 409-427
• 204 Masur H, Rosen P P, Armstrong D. Pulmonary disease caused by Candida species.  Am J Med. 1977;  63 914-925
• 205 Masur H. Prevention and treatment of Pneumocystis pneumonia.  N Engl J Med. 1992;  327 1853-1860
• 206 Mattei D, Mordini N, Lo Nigro C. et al . Successful treatment of Acremonium fungemia with voriconazole.  Mycoses. 2003;  46 511-514
• 207 McGinnis M R, Pasarell L. In vitro testing of susceptibilities of filamentous ascomycetes to voriconazole, itraconazole, and amphotericin B, with consideration of phylogenetic implications.  J Clin Microbiol. 1998;  36 2353-2355
• 208 Melamed R, Leibovitz E, Abramson O. et al . Successful non-surgical treatment of Candida tropicalis endocarditis with liposomal amphotericin-B (AmBisome).  Scand J Infect Dis. 2000;  32 86-89
• 209 Meletiadis J, Mouton J W, Meis J F. et al . In vitro drug interaction modeling of combinations of azoles with terbinafine against clinical Scedosporium prolificans isolates.  Antimicrob Agents Chemother. 2003;  47 106-117
• 210 Meunier F, Prentice H G, Ringden O. Liposomal amphotericin B (AmBisome™): safety data from a phase II/III clinical trial.  J Antimicrob Chemother. 1991;  28 (Suppl B) S83-S91
• 211 Meunier F. Candidiasis.  Eur J Clin Microbiol Infect Dis. 1989;  8 438-447
• 212 Meunier-Carpentier F, Kiehn T E, Armstrong D. Fungemia in the immuno-compromised host. Changing patterns, antigenemia, high mortality.  Am J Med. 1981;  71 363-370
• 213 Meyers J D, Pifer L L, Sale G E. et al . The value of Pneumocystis carinii antibody and antigen detection for diagnosis of Pneumocystis carinii pneumonia after marrow transplantation.  Am Rev Respir Dis. 1979;  120 1283-1287
• 214 Meyers J D. Fungal infections in bone marrow transplant patients.  Sem Oncol. 1990;  17 (Suppl 6) S10-S13
• 215 Mora-Duarte J, Betts R, Rotstein C. et al., Caspofungin Invasive Candidiasis Study Group . Comparison of caspofungin and amphotericin B for invasive candidiasis.  N Engl J Med. 2002;  347 2020-2029
• 216 Morrison V A, Weisdorf D J. The spectrum of Malassezia infections in the bone marrow transplant population.  Bone Marrow Transplant. 2000;  26 645-648
• 217 Morselli P L. Clinical pharmacology of the perinatal period and early infancy.  Clin Pharmacokinetics. 1989;  17 (Suppl 1) S13-S28
• 218 Mosquera J, Denning D W. Azole cross-resistance in Aspergillus fumigatus.  Antimicrob Agents Chemother. 2002;  46 556-557
• 219 Nath C E, Shaw P J, Gunning R. et al . Amphotericin B in children with malignant disease: a comparison of the toxicities and pharmacokinetics of amphotericin B administered in dextrose versus lipid emulsion.  Antimicrob Agents Chemother. 1999;  43 1417-1423
• 220 Nejjam F, Zagula M, Cabiac M D. et al . Pilot study of terbinafine in children suffering from tinea capitis: evaluation of efficacy, safety and pharmacokinetics.  Br J Dermatol. 1995;  132 98-105
• 221 Ng V L, Yajko D M, Hadley W K. Extrapulmonary pneumocystosis.  Clin Microbiol Rev. 1997;  10 401-418
• 222 Nguyen M H, Peacock J E, Morris A J. et al . The changing face of candidemia: emergence of non-Candida albicans species and antifungal resistance.  Am J Med. 1996;  100 617-623
• 223 Nguyen M H, Yu V L. Meningitis caused by Candida species: an emerging problem in neurosurgical patients.  Clin Infect Dis. 1995;  21 323-327
• 224 Novelli V, Holzel H. Safety and tolerability of fluconazole in children.  Antimicrob Agents Chemother. 1999;  43 1955-1960
• 225 Nucci M, Marr K A, Queiroz-Telles F. et al . Fusarium infection in hematopoietic stem cell tranplant recipients.  Clin Infect Dis. 2004;  38 1237-1242
• 226 Obayashi T, Yoshida M, Mori T. et al . Plasma (1→3)-beta-D-glucan measurement in diagnosis of invasive deep mycosis and fungal febrile episodes.  Lancet. 1995;  345 17-20
• 227 Offner F, Cordonnier C, Ljungman P. et al . Impact of previous aspergillosis on the outcome of bone marrow transplantation.  Clin Infect Dis. 1998;  26 1098-1103
• 228 Ognibene F P, Gill V J, Pizzo P A. et al . Induced sputum to diagnose Pneumocystis carinii pneumonia in immunosuppressed pediatric patients.  J Pediatr. 1989;  115 430-433
• 229 Ortoneda M, Capilla J, Pastor F J. et al . Interaction of granulocyte colony-stimulating factor and high doses of liposomal amphotericin B in the treatment of systemic murine scedosporiosis.  Diagn Microbiol Infect Dis. 2004;  50 247-251
• 230 Ostrosky-Zeichner L, Oude Lashof A M, Kullberg B J. et al . Voriconazole salvage treatment of invasive candidiasis.  Eur J Clin Microbiol Infect Dis. 2003;  22 651-655
• 231 Ostrosky-Zeichner L, Rex J H, Bennett J. et al . Deeply invasive candidiasis.  Infect Dis Clin North Am. 2002;  16 821-835
• 232 Pagano L, Mele L, Fianchi L. et al . Chronic disseminated candidiasis in patients with hematologic malignancies. Clinical features and outcome of 29 episodes.  Haematologica. 2002;  87 535-541
• 233 Pagano L, Offidani M, Fianchi L. et al . GIMEMA Infection Program (Gruppo Italiano Malattie EMatologiche dell'Adulto). Mucormycosis in hematologic patients.  Haematologica. 2004;  89 207-214
• 234 Pagano L, Ricci P, Tonso A. et al., GIMEMA Infection Program (Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto) . Mucormycosis in patients with haematological malignancies: a retrospective clinical study of 37 cases.  Br J Haematol. 1997;  99 331-336
• 235 Pappas P G, Rex J H, Sobel J D. et al., Infectious Diseases Society of America . Guidelines for treatment of candidiasis.  Clin Infect Dis. 2004;  38 161-189
• 236 Partap R, Kaur I, Chakrabarti A. et al . Single-dose fluconazole versus itraconazole in pityriasis versicolor.  Dermatology. 2004;  208 55-59
• 237 Pastakia B, Shawker T H, Thaler M. et al . Hepatosplenic candidiasis: wheels within wheels.  Radiology. 1988;  166 417-421
• 238 Perea S, Patterson T F. Antifungal resistance in pathogenic fungi.  Clin Infect Dis. 2002;  35 1073-1080
• 239 Perfect J R, Casadevall A. Cryptococcosis.  Infect Dis Clin North Am. 2002;  16 837-874
• 240 Perfect J R, Marr K A, Walsh T J. et al . Voriconazole treatment for less-common, emerging, or refractory fungal infections.  Clin Infect Dis. 2003;  36 1122-1131
• 241 Pfaller M A, Diekema D J. Rare and emerging opportunistic fungal pathogens: concern for resistance beyond Candida albicans and Aspergillus fumigatus.  J Clin Microbiol. 2004;  42 4419-4431
• 242 Pfaller M A, Marco F, Messer S A. et al . In vitro activity of two echinocandin derivatives, LY303366 and MK-0991 (L-743,792), against clinical isolates of Aspergillus, Fusarium, Rhizopus, and other filamentous fungi.  Diagn Microbiol Infect Dis. 1998;  30 251-255
• 243 Phillips P, De Beule K, Frechette G. et al . A double-blind comparison of itraconazole oral solution and fluconazole capsules for the treatment of oropharyngeal candidiasis in patients with AIDS.  Clin Infect Dis. 1998;  26 1368-1373
• 244 Phillips P, Shafran S, Garber G. et al., Canadian Candidemia Study Group . Multicenter randomized trial of fluconazole versus amphotericin B for treatment of candidemia in non-neutropenic patients.  Eur J Clin Microbiol Infect Dis. 1997;  16 337-345
• 245 Pierrotti L C, Baddour L M. Fungal endocarditis, 1995-2000.  Chest. 2002;  122 302-310
• 246 Pifer L L, Hughes W T, Stagno S. et al . Pneumocystis carinii infection: evidence for high prevalence in normal and immunosuppressed children.  Pediatrics. 1978;  61 35-41
• 247 Pizzo P A, Robichaud K J, Gill F A. et al . Empiric antibiotic and antifungal therapy for cancer patients with prolonged fever and granulocytopenia.  Am J Med. 1982;  72 101-111
• 248 Pottratz S T. Pneumocystis carinii interactions with respiratory epithelium.  Semin Respir Infect. 1998;  13 323-329
• 249 Powderly W G, Mayer K H, Perfect J R. Diagnosis and treatment of oropharyngeal candidiasis in patients infected with HIV: a critical reassessment.  AIDS Res Hum Retrovir. 1999;  15 1405-1412
• 250 Prabhu R M, Patel R. Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment.  Clin Microbiol Infect. 2004;  10 (Suppl 1) S31-S47
• 251 Prentice H G, Hann I M, Herbrecht R. et al . A randomized comparison of liposomal versus conventional amphotericin B for the treatment of pyrexia of unknown origin in neutropenic patients.  Br J Haematol. 1997;  98 711-718
• 252 Price T H, Bowden R A, Boeckh M. et al . Phase I/II trial of neutrophil transfusions from donors stimulated with G-CSF and dexamethasone for treatment of patients with infections in hematopoietic stem cell transplantation.  Blood. 2000;  95 3302-3309
• 253 Queiroz-Telles F, McGinnis M R, Salkin I. et al . Subcutaneous mycoses.  Infect Dis Clin North Am. 2003;  17 59-85
• 254 Radford S A, Johnson E M, Warnock D W. In vitro studies of activity of voriconazole (UK-109,496), a new triazole antifungal agent, against emerging and less-common mold pathogens.  Antimicrob Agents Chemother. 1997;  41 841-843
• 255 Rangel-Guerra R A, Martinez H R, Saenz C. et al . Rhinocerebral and systemic mucormycosis. Clinical experience with 36 cases.  J Neurol Sci. 1996;  143 19-30
• 256 Rantala A, Lehtonen O P, Kuttila K. et al . Diagnostic factors for postoperative candidosis in abdominal surgery.  Ann Chir Gynaecol. 1991;  80 323-328
• 257 Reagan D R, Pfaller M A, Hollis R J. et al . Characterization of the sequence of colonization and nosocomial candidemia using DNA fingerprinting and a DNA probe.  J Clin Microbiol. 1990;  28 2733-2738
• 258 Redding S W, Zellars R C, Kirkpatrick W R. et al . Epidemiology of oropharyngeal Candida colonization and infection in patients receiving radiation for head and neck cancer.  J Clin Microbiol. 1999;  37 3896-3900
• 259 Reef S E, Levine W C, McNeil M M. et al . Treatment options for vulvovaginal candidiasis, 1993.  Clin Infect Dis. 1995;  20 (Suppl 1) S80-S90
• 260 Restrepo A. Paracoccidioidomycosis. In: Dismukes WE, Pappas PG, Sobel JD (eds). Clinical Mycology. 1st ed., Oxford University Press, Oxford/New York 2003; 328-345
• 261 Reuben A, Anaissie E, Nelson P E. et al . Antifungal susceptibility of 44 clinical isolates of Fusarium species determined by using a broth microdilution method.  Antimicrob Agents Chemother. 1989;  33 1647-1649
• 262 Revankar S G, Sutton D A, Rinaldi M G. Primary central nervous system phaeohyphomycosis: a review of 101 cases.  Clin Infect Dis. 2004;  38 206-216
• 263 Rex J H, Bennett J E, Sugar A M. et al . A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia.  New Engl J Med. 1994;  331 1325-1330
• 264 Rex J H, Larsen R A, Dismukes W E. et al . Catastrophic visual loss due to Cryptococcus neoformans meningitis.  Medicine (Baltimore). 1993;  72 207-224
• 265 Rex J H, Pappas P G, Karchmer A W. et al., National Institute of Allergy and Infectious Diseases Mycoses Study Group . A randomized and blinded multicenter trial of high-dose fluconazole plus placebo versus fluconazole plus amphotericin B as therapy for candidemia and its consequences in nonneutropenic subjects.  Clin Infect Dis. 2003;  36 1221-1228
• 266 Rex J H, Pfaller M A, Galgiani J N. et al., Subcommittee on Antifungal Susceptibility Testing of the National Committee for Clinical Laboratory Standards . Development of interpretive breakpoints for antifungal susceptibility testing: conceptual framework and analysis of in vitro-in vivo correlation data for fluconazole, itraconazole, and Candida infections.  Clin Infect Dis. 1997;  24 235-247
• 267 Rex J H, Pfaller M A. Has antifungal susceptibility testing come of age?.  Clin Infect Dis. 2002;  35 982-989
• 268 Rex J H, Walsh T J, Nettleman M. et al . Need for alternative trial designs and evaluation strategies for therapeutic studies of invasive mycoses.  Clin Infect Dis. 2001;  33 95-106
• 269 Ribaud P, Chastang C, Latge J P. et al . Survival and prognostic factors of invasive aspergillosis after allogeneic bone marrow transplantation.  Clin Infect Dis. 1999;  28 322-330
• 270 Ridola V, Chachaty E, Raimondo G. et al . Candida infections in children treated with conventional chemotherapy for solid tumors (transplant recipients excluded): The Institut Gustave Roussy Pediatrics Department experience.  Pediatr Blood Cancer. 2004;  42 332-337
• 271 Ringden O, Meunier F, Tollemar J. et al . Efficacy of amphotericin B encapsulated in liposomes (AmBisome) in the treatment of invasive fungal infections in immunocompromised patients.  J Antimicrob Chemother. 1991;  28 (Suppl B) 73-82
• 272 Ritter J, Roos N. Special aspects related to invasive fungal infections in children with cancer. In: Meunier F (ed). Bailleres Clinical Infectious Diseases. London, Philadelphia, Sydney, Tokio, Toronto 1995; 179-204
• 273 Rodriguez L J, Rex J H, Anaissie E J. Update on invasive candidiasis.  Adv Pharmacol. 1997;  37 349-400
• 274 Roilides E, Bibashi E, Acritidou E. et al . Acremonium fungemia in two immunocompromised children.  Pediatr Infect Dis J. 1995;  14 548-550
• 275 Roilides E, Dignani M C, Anaissie E J. et al . The role of immunoreconstitution in the management of refractory opportunistic fungal infections.  Med Mycol. 1998;  36 (Suppl 1) S12-S25
• 276 Roseeuw D, De Doncker P. New approaches to the treatment of onychomycosis.  J Am Acad Dermatol. 1993;  29 S45-S50
• 277 Rosenberg D M, McCarthy W, Slavinsky J. et al . Atovaquone suspension for treatment of Pneumocystis carinii pneumonia in HIV-infected patients.  AIDS. 2001;  15 211-214
• 278 Ruhnke M, Bohme A, Buchheidt D. et al., Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) . Diagnosis of invasive fungal infections in hematology and oncology - guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO).  Ann Hematol. 2003;  82 (Suppl 2) S141-S148
• 279 Saag M S, Cloud G A, Graybill J R. et al., National Institute of Allergy and Infectious Diseases Mycoses Study Group . A comparison of itraconazole versus fluconazole as maintenance therapy for AIDS-associated cryptococcal meningitis.  Clin Infect Dis. 1999;  28 291-296
• 280 Saag M S, Fessel W J, Kaufman C A. et al . Treatment of fluconazole-refractory oropharyngeal candidiasis with itraconazole oral solution in HIV-positive patients.  AIDS Res Hum Retroviruses. 1999;  15 1413-1417
• 281 Saag M S, Graybill R J, Larsen R A. et al., Infectious Diseases Society of America . Practice guidelines for the management of cryptococcal disease.  Clin Infect Dis. 2000;  30 710-718
• 282 Safrin S, Finkelstein D M, Feinberg J. et al., ACTG 108 Study Group . Comparison of three regimens for treatment of mild to moderate Pneumocystis carinii pneumonia in patients with AIDS. A double-blind, randomized, trial of oral trimethoprim-sulfamethoxazole, dapsone-trimethoprim, and clindamycin-primaquine.  Ann Intern Med. 1996;  124 792-802
• 283 Samonis G, Rolston K, Karl C. et al . Prophylaxis of oropharyngeal candidiasis with fluconazole.  Rev Infect Dis. 1990;  12 (Suppl 3) S369-S373
• 284 Sandin R L, Fang T T, Hiemenz J W. et al . Malassezia furfur folliculitis in cancer patients. The need for interaction of microbiologist, surgical pathologist, and clinician in facilitating identification by the clinical microbiology laboratory.  Ann Clin Lab Sci. 1993;  23 377-384
• 285 Sattler F R, Cowan R, Nielsen D M. et al . Trimethoprim-sulfamethoxazole compared with pentamidine for treatment of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A prospective, noncrossover study.  Ann Intern Med. 1988;  10 280-287
• 286 Sattler F R, Frame P, Davis R. et al . Trimetrexate with leucovorin versus trimethoprim-sulfamethoxazole for moderate to severe episodes of Pneumocystis carinii pneumonia in patients with AIDS: a prospective, controlled multicenter investigation of the AIDS Clinical Trials Group Protocol 029/031.  J Infect Dis. 1994;  170 165-172
• 287 Savage D G, Taylor P, Blackwell J. et al . Paranasal sinusitis following allogeneic bone marrow transplant.  Bone Marrow Transplant. 1997;  19 55-59
• 288 Saxen H, Hoppu K, Pohjavuori M. Pharmacokinetics of fluconazole in very low birth weight infants during the first two weeks of life.  Clin Pharmacol Ther. 1993;  54 269-277
• 289 Scarcella A, Pasquariello M B, Giugliano B. et al . Liposomal amphotericin B treatment for neonatal fungal infections.  Pediatr Infect Dis J. 1998;  17 146-148
• 290 Schaffner A, Douglas H, Braude A. Selective protection against conidia by mononuclear and against mycelia by polymorphonuclear phagocytes in resistance to Aspergillus.  J Clin Invest. 1982;  69 617-631
• 291 Schmitt C, Perel Y, Harousseau J L. et al . Pharmacokinetics of itraconazole oral solution in neutropenic children during long-term prophylaxis.  Antimicrob Agents Chemother. 2001;  45 1561-1564
• 292 Schwartz J. The diagnosis of deep mycoses by morphologic methods.  Hum Pathol. 1982;  13 519-533
• 293 Seay R E, Larson T A, Toscano J P. et al . Pharmacokinetics of fluconazole in immunocompromised children with leukemia or other hematologic diseases.  Pharmacotherapy. 1995;  15 52-58
• 294 Semelka R C, Shoenut J P, Greenberg H M. et al . Detection of acute and treated lesions of hepatosplenic candidiasis: comparison of dynamic contrast-enhanced CT and MR imaging.  J Magn Reson Imaging. 1992;  2 341-345
• 295 Sepkowitz K A. Pneumocystis carinii pneumonia in patients without AIDS.  Clin Infect Dis. 1993;  17 (Suppl 2) S416-S422
• 296 Sharkey P K, Graybill J R, Rinaldi M G. et al . Itraconazole treatment of phaeohyphomycosis.  J Am Acad Dermatol. 1990;  23 577-586
• 297 Silverman S, Luangjarmekorn L, Greenspan D. Occurrence of oral Candida in irradiated head and neck cancer patients.  J Oral Med. 1984;  39 194-196
• 298 Simone J V, Holland E, Johnson W. Fatalities during remission of childhood leukemia.  Blood. 1972;  39 759-770
• 299 Sirisanthana T, Supparatpinyo K, Perriens J. et al . Amphotericin B and itraconazole for treatment of disseminated Penicillium marneffei infection in human immunodeficiency virus-infected patients.  Clin Infect Dis. 1998;  26 1107-1110
• 300 Slavin M A, Osborne B, Adams R. et al . Efficacy and safety of fluconazole prophylaxis for fungal infections after marrow transplantation - a prospective, randomized, double-blind study.  J Infect Dis. 1995;  171 1545-1552
• 301 Slivka A, Wen P Y, Shea W M. et al . Pneumocystis carinii pneumonia during steroid taper in patients with primary brain tumors.  Am J Med. 1993;  94 216-219
• 302 Smego R A, Nagar S. et al . A meta-analysis of salvage therapy for Pneumocystis carinii pneumonia.  Arch Intern Med. 2001;  161 1529-1533
• 303 Smego R A, Perfect J R, Durack D T. Combined therapy with amphotericin B and 5-fluorocytosine for Candida meningitis.  Rev Infect Dis. 1984;  6 791-801
• 304 Sobel J D, Kauffman C A, McKinsey D. et al., The National Institute of Allergy and Infectious Diseases (NIAID) Mycoses Study Group . A randomized, double-blind study of treatment with fluconazole and placebo.  Clin Infect Dis. 2000;  30 19-24
• 305 Sobel J D, Wiesenfeld H C, Martens M. et al . Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis.  N Engl J Med. 2004;  351 876-883
• 306 Starke J R, Mason O, Kramer W G. et al . Pharmacokinetics of amphotericin B in infants and children.  J Infect Dis. 1987;  155 766-774
• 307 Steinbach W J, Benjamin D K, Kontoyiannis D P. et al . Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases.  Clin Infect Dis. 2004;  39 192-198
• 308 Stevens D A, Kan V L, Judson M A. et al., Infectious Diseases Society of America . Practice guidelines for diseases caused by Aspergillus.  Clin Infect Dis. 2000;  30 696-709
• 309 Stevens D A, Lee J Y. NIAID Mycoses Study Group criteria . Analysis of compassionate use itraconazole therapy for invasive aspergillosis.  Arch Intern Med. 1997;  157 1857-1862
• 310 Sun Q N, Fothergill A W, McCarthy D I. et al . In vitro activities of posaconazole, itraconazole, voriconazole, amphotericin B, and fluconazole against 37 clinical isolates of zygomycetes.  Antimicrob Agents Chemother. 2002;  46 1581-1582
• 311 Sunenshine P J, Schwartz R A, Janniger C K. et al . Tinea versicolor.  Int J Dermatol. 1998;  37 648-655
• 312 Sutton D A, Sanche S E, Revankar S G. et al . In vitro amphotericin B resistance in clinical isolates of Aspergillus terreus, with a head-to-head comparison to voriconazole.  J Clin Microbiol. 1999;  37 2343-2345
• 313 Thaler M, Bacher J, O'Leary T. et al . Evaluation of single-drug and combination antifungal therapy in an experimental model of candidiasis in rabbits with prolonged neutropenia.  J Infect Dis. 1988;  158 80-88
• 314 Thaler M, Pastakia B, Shawker T H. et al . Hepatic candidiasis in cancer patients: the evolving picture of the syndrome.  Ann Intern Med. 1988;  108 88-100
• 315 Toma E, Thorne A, Singer J. et al., CTN-PCP Study Group . Clindamycin with primaquine vs. Trimethoprim-sulfamethoxazole therapy for mild and moderately severe Pneumocystis carinii pneumonia in patients with AIDS: a multicenter, double-blind, randomized trial (CTN 004).  Clin Infect Dis. 1998;  27 524-530
• 316 Travis L B, Roberts G D, Wilson W R. Clinical significance of Pseudallescheria boydii: a review of 10 years' experience.  Mayo Clin Proc. 1985;  60 531-537
• 317 Troke P F, Schwartz S, Ruhnke M. et al .Voriconazole therapy in 86 patients with CNS-aspergillosis: a retrospective analysis. In: Abstracts of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Chemotherapy, Washington, DC 2003; abstr. M-1755: 476
• 318 Tuan I Z, Dennison D, Weisdorf D J. Pneumocystis carinii pneumonitis following bone marrow transplantation.  Bone Marrow Transplant. 1992;  10 267-272
• 319 US Public Health Services/Infectious Diseases Society of America . Prevention of opportunistic Infections Working Group. 1999 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus.  Clin Infect Dis. 2000;  30 S29-S65
• 320 der Horst C M van, Saag M S, Cloud G A. et al., National Institute of Allergy and Infectious Diseases Mycoses Study Group and AIDS Clinical Trials Group . Treatment of cryptococcal meningitis associated with the acquired immunodeficiency syndrome.  N Engl J Med. 1997;  337 15-21
• 321 der Straten M R van, Hossain M A, Ghannoum M A. Cutaneous infections dermatophytosis, onychomycosis, and tinea versicolor.  Infect Dis Clin North Am. 2003;  17 87-112
• 322 Vartivarian S, Smith C B. Pathogenesis, host resistance, and predisposing factors. In: Bodey GP (ed). Candidiasis. Pathogenesis, Diagnosis, and Treatment. 2nd ed. Raven Press, New York 1993; 59-84
• 323 Vermes A, Der Sijs H van, Guchelaar H J. Flucytosine: correlation between toxicity and pharmacokinetic parameters.  Chemotherapy. 2000;  46 86-94
• 324 Villanueva A, Arathoon E G, Gotuzzo E. et al . A randomized double-blind study of caspofungin versus amphotericin for the treatment of candidal esophagitis.  Clin Infect Dis. 2001;  33 1529-1535
• 325 Villanueva A, Gotuzzo E, Arathoon E G. et al . A randomized double-blind study of caspofungin versus fluconazole for the treatment of esophageal candidiasis.  Am J Med. 2002;  113 294-299
• 326 Viscoli C, Castagnola E, Giacchino M. et al . Bloodstream infections in children with cancer: a multicentre surveillance study of the Italian Association of Paediatric Haematology and Oncology.  Eur J Cancer. 1999;  35 770-774
• 327 Eiff M von, Roos N, Schulten R. et al . Pulmonary aspergillosis: early diagnosis improves survival.  Respiration. 1995;  62 341-347
• 328 Wald A, Leichsenring W, Burik J A van. et al . Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation.  J Infect Dis. 1997;  175 1459-1466
• 329 Walmsley S, Devi S, King S. et al . Invasive Aspergillus infections in a pediatric hospital: a ten-year review.  Pediatr Infect Dis J. 1993;  12 673-682
• 330 Walsh T J, Dixon D M. Nosocomial aspergillosis: environmental micro-biology, hospital epidemiology, diagnosis and treatment.  Eur J Epidemiol. 1989;  5 131-142
• 331 Walsh T J, Adamson P C, Seibel N L. et al .Pharmacokinetics of caspofungin in pediatric patients. In: Abstracts of the 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, DC 2002; abstract M-896: 395
• 332 Walsh T J, Chanock S J. Diagnosis of invasive fungal infections: advances in nonculture systems.  Curr Clin Top Infect Dis. 1998;  18 101-153
• 333 Walsh T J, Finberg R W, Arndt C. et al., National Institute of Allergy and Infectious Diseases Mycoses Study Group . Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia.  N Engl J Med. 1999;  340 764-771
• 334 Walsh T J, Gonzalez C, Lyman C A. et al . Invasive fungal infections in children: recent advances in diagnosis and treatment.  Adv Pediatr Infect Dis. 1996;  11 187-290
• 335 Walsh T J, Goodman J L, Pappas P. et al . Safety, tolerance, and pharmacokinetics of high-dose liposomal amphotericin B (AmBisome) in patients infected with Aspergillus species and other filamentous fungi: maximum tolerated dose study.  Antimicrob Agents Chemother. 2001;  45 3487-3496
• 336 Walsh T J, Gray W C. Candida epiglottitis in immunocompromised patients.  Chest. 1987;  91 482-485
• 337 Walsh T J, Groll A, Hiemenz J. et al . Infections due to emerging and uncommon medically important fungal pathogens.  Clin Microbiol Infect. 2004;  10 (Suppl 1) S48-S66
• 338 Walsh T J, Hiemenz J W, Anaissie E J. Recent progress and current problems in treatment of invasive fungal infections in neutropenic patients.  Infect Dis Clin North Amer. 1996;  10 365-400
• 339 Walsh T J, Karlsson M O, Driscoll T. et al . Pharmacokinetics and safety of intravenous voriconazole in children after single- or multiple-dose administration.  Antimicrob Agents Chemother. 2004;  48 2166-2172
• 340 Walsh T J, Lee J W, Melcher G P. et al . Experimental Trichosporon infection in persistently granulocytopenic rabbits: implications for pathogenesis, diagnosis, and treatment of an emerging opportunistic mycosis.  J Infect Dis. 1992;  166 121-133
• 341 Walsh T J, Lutsar I, Driscoll T. et al . Voriconazole in the treatment of aspergillosis, scedosporiosis and other invasive fungal infections in children.  Pediatr Infect Dis J. 2002;  21 240-248
• 342 Walsh T J, Melcher G P, Rinaldi M G. et al . Trichosporon beigelii, an emerging pathogen resistant to amphotericin B.  J Clin Microbiol. 1990;  28 1616-1622
• 343 Walsh T J, Newman K R, Moody M. et al . Trichosporonosis in patients with neoplastic disease.  Medicine (Baltimore). 1986;  65 268-279
• 344 Walsh T J, Pappas P, Winston D J. et al., National Institute of Allergy and Infectious Diseases Mycoses Study Group . Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever.  N Engl J Med. 2002;  346 225-234
• 345 Walsh T J, Peter J, McGough D A. et al . Activities of amphotericin B and antifungal azoles alone and in combination against Pseudallescheria boydii.  Antimicrob Agents Chemother. 1995;  39 1361-1364
• 346 Walsh T J, Petraitis V, Petraitiene R. et al . Experimental pulmonary aspergillosis due to Aspergillus terreus: pathogenesis and treatment of an emerging fungal pathogen resistant to amphotericin B.  J Infect Dis. 2003;  188 305-319
• 347 Walsh T J, Roden M, Roilides E. et al . Concepts in design of comparative clinical trials of antifungal therapy in neutropenic patients.  Int J Antimicrob Agents. 2000;  16 151-156
• 348 Walsh T J, Teppler H, Donowitz G R, Maertens J A, Baden L R, Dmoszynska A, Cornely O A, Bourque M R, Lupinacci R J, Sable C A, dePauw B E. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia.  N Engl J Med. 2004;  351 1391-1402
• 349 Walsh T J, Whitcomb P, Piscitelli S. et al . Safety, tolerance, and pharmacokinetics of amphotericin B lipid complex in children with hepatosplenic candidiasis.  Antimicrob Agents Chemother. 1997;  41 1944-1948
• 350 Walsh T J, Whitcomb P O, Revankar S G. et al . Successful treatment of hepatosplenic candidiasis through repeated cycles of chemotherapy and neutropenia.  Cancer. 1995;  76 2357-2362
• 351 Walzer P D. Mandell, Douglas and Bennet's Principles and Practice of Infectious Diseases. In: Mandell GL, Bennet JR, Dolin R (eds). 5th edition. Pneumocystis carinii. Churchill Livingstone, Philadelphia 2000; 2781-2795
• 352 Wells G M, Gajjar A, Pearson T A. et al . Brief report. Pulmonary cryptosporidiosis and Cryptococcus albidus fungemia in a child with acute lymphocytic leukemia.  Med Pediatr Oncol. 1998;  31 544-546
• 353 Wey S B, Mori M, Pfaller M A. et al . Risk factors for hospital-acquired candidemia. A matched case-control study.  Arch Intern Med. 1989;  149 2349-2353
• 354 Wheat L J. Rapid diagnosis of invasive aspergillosis by antigen detection.  Transpl Infect Dis. 2003;  5 158-166
• 355 Wheat J, Sarosi G, McKinsey D. et al., Infectious Diseases Society of America . Practice guidelines for the management of patients with histoplasmosis.  Clin Infect Dis. 2000;  30 688-695
• 356 Wilcox C M, Darouiche R O, Laine L. et al . A randomized, double-blind comparison of itraconazole oral solution and fluconazole tablets in the treatment of esophageal candidiasis.  J Infect Dis. 1997;  176 227-232
• 357 Wilcox C M, Straub R F, Alexander L N. et al . Etiology of esophageal disease in human immunodeficiency virus-infected patients who fail antifungal therapy.  Am J Med. 1996;  101 599-604
• 358 Wildfeuer A, Seidl H P, Paule I. et al . In vitro activity of voriconazole against yeasts, moulds and dermatophytes in comparison with fluconazole, amphotericin B and griseofulvin.  Arzneimittelforschung.. 1997;  47 1257-1263
• 359 Wingard J R. Infections due to resistant Candida species in patients with cancer who are receiving chemotherapy.  Clin Infect Dis. 1994;  19 (Suppl 1) S49-S53
• 360 Winston D J, Chandrasekar P H, Lazarus H M. et al . Fluconazole prophylaxis of fungal infections in patients with acute leukemia. Results of a randomized placebo-controlled, double-blind, multicenter trial.  Ann Intern Med. 1993;  118 495-503
• 361 Winston D J, Hathorn J W, Schuster M G. et al . A multicenter, randomized trial of fluconazole versus amphotericin B for empiric antifungal therapy of febrile neutropenic patients with cancer.  Am J Med. 2000;  108 282-289
• 362 Wong K, Waters C M, Walesby R K. Surgical management of invasive pulmonary aspergillosis in immunocompromised patients.  Eur J Cardiothorac Surg. 1992;  6 138-142
• 363 Yeghen T, Kibbler C C, Prentice H G. et al . Management of invasive pulmonary aspergillosis in hematology patients: a review of 87 consecutive cases at a single institution.  Clin Infect Dis. 2000;  31 859-868
• 364 Yu V L, Muder R R, Poorsattar A. Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis. Results from a three-year prospective study.  Am J Med. 1986;  81 249-254