Management of Fungal Infections in Immunocompromised Patients at University of Ilorin Teaching Hospital

Invasive fungal infections in immunocompromised patients, including those receiving chemotherapy, corticosteroids, or antiretroviral therapy, are associated with high mortality in Nigerian tertiary hospitals where diagnostic and therapeutic resources are constrained. This study reviews the management of fungal infections in immunocompromised patients at the University of Ilorin Teaching Hospital (UITH), Kwara State, North Central Nigeria. A retrospective review of 120 immunocompromised patient case files over three years was conducted, supplemented by interviews with 15 treating physicians and a laboratory capability assessment. Fungi were identified by cultural and morphological methods and, where available, by VITEK 2 automated identification. Antifungal susceptibility was assessed for key isolates. Candida species accounted for 58 percent of fungal infections, Cryptococcus neoformans for 22 percent, and Aspergillus fumigatus for 14 percent. Fluconazole was the most commonly prescribed antifungal but resistance was documented in 19 percent of non-albicans Candida isolates. Diagnosis was delayed beyond 72 hours in 64 percent of cases, contributing to treatment initiation delays. Cryptococcal antigen testing was unavailable at UITH, requiring referral in all suspected cryptococcosis cases. Professional recommendations include UITH procurement of cryptococcal antigen lateral flow tests, mould-active antifungal agent availability, and a clinical fungal infection management protocol tailored to UITH's immunocompromised patient burden. Keywords: fungal infection, immunocompromised, Candida, UITH Ilorin, antifungal management