Introduction:

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in patients with hematological malignancies and hematopoietic stem cell transplants.

Objective:

To describe the clinical and microbiological profile of IFI episodes in adult patients with hematological malignancies at the Central Hospital of the Instituto de Prevision Social, Asunción, Paraguay.

Materials and methods:

Descriptive, retrospective study conducted in the Department of Internal Medicine between 2022 and 2024. Adult patients with hematological malignancies or a history of hematopoietic stem cell transplantation who presented with IFIs were included. Standardized microbiological methods were used. Clinical, epidemiological, and therapeutic variables were described using descriptive statistics.

Results:

Thirty-four patients were included, with a predominance of females. The most frequent diagnoses were acute myeloid leukemia and non-Hodgkin lymphoma. Thirty-five-point two percent had received hematopoietic stem cell transplantation, predominantly allogeneic. The most frequent risk factors were recent use of antimicrobials, chemotherapy, a central venous catheter, and high-dose corticosteroid therapy. The most common IFIs were invasive pulmonary aspergillosis and candidemia caused by Candida parapsilosis. The main treatment was voriconazole, although in some cases, amphotericin B was required due to availability issues. In-hospital mortality was 17.6%, concentrated in patients with invasive aspergillosis.

Conclusions:

IFIs present diverse characteristics depending on patient risk factors and the institutional microbiological profile. These findings highlight the need for local surveillance strategies, early diagnosis, and timely treatment, as well as the implementation of prophylaxis protocols adapted to each context.

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