Fungus among us.
In thisretrospective study of >1700 patients with NSCLC who developed grade 3+ radiation pneumonitis after radiation, nearly half (45%) developed secondary lung infections. Of these, 85% of infections were by gram negative bacteria, 28% had multiple bacterial infections, and 30% had bacterial and fungal infections with Candida being the most common fungal species (two-thirds of all co-infections). Nearly a quarter of these patients (22%) died, and bacterial/fungal co-infection, poor performance status, inappropriate empiric antibiotic coverage, and lack of empiric antifungal coverage were associated with mortality. So, when considering empiric antimicrobial therapy in the setting of radiation pneumonitis, consider covering for fungal co-infection. | Mei, Int J Radiat Oncol Biol Phys 2021