Candida and Aspergillus infections in critically ill patients

The incidence of fungal infections in the intensive care unit (ICU) is increasing, and systemic infection is associated with considerable morbidity and mortality. The diagnosis of fungal infection remains difficult in the absence of specific techniques able to distinguish colonization from invasive and disseminated disease. The treatment of fungal infections can be considered as prophylactic, early presumptive, empiric, or definitive. Several anti-fungal agents are effective, including amphotericin B and fluconazole, and others will be available in the near future. Immunomodulatory therapies are under investigation. We review the epidemiology, diagnosis and management of infections caused by the most common fungal pathogens, Candida and Aspergillus, in ICU patients.