Update on management of fungal infections in childhood malignancy

Fungal infections are important causes of life-threatening infection in patients with certain cancer and undergoing intensive chemotherapy. Fungi have been reported to be responsible for two thirds of all super infections in patients with hematological malignancies and associated neutropenia.The conventional microbiological, histological and radiological techniques remain the cornerstone of diagnosis but are insensitive and have a limited impact on clinical decision-making. There is an urgent need for new and efficient diagnostic methods. These tests should be fast and highly sensitive. With the advance of molecular tools, new fungal species and new mechanisms of resistance will be clarified. DNA and RNA-based methods hold promise for improved sensitivity and specificity, but these methods will require extensive validation in clinical studies. Finally, costs are also very important in selecting an appropriate diagnostic test for invasive fungal infections.The severity of IFI in immunocoprimised patients with hematological malignancies has led to the development of various preventive and therapeutic strategies that offer many of the newer antifungal agents with important advances in spectrum of activity, mechanisms of action, and tolerability by patients. The availability of those new compounds provides opportunities for new and innovative approaches to the treatment and prevention of life-threating fungal infections in these highly vulnerable patients.