Chen XC, et al. - In hematology patients with severe agranulocytosis, breakthrough infections may occur as a result of antifungal prophylaxis. Researchers sought to report on the distribution of Candida species and investigated risk factors for mortality in such patients. In addition, they examined disparities in the incidence and mortality of breakthrough candidemia between patients who did or did not receive an allogeneic hematopoietic stem cell transplant. They analyzed clinical and microbiological data of 71 patients with hematologic malignancies and breakthrough candidemia, 17 of whom received allogeneic transplants. The allogeneic transplant group was identified exhibiting higher breakthrough candidemia-related mortality, although the groups did not differ significantly in the incidence. Candida tropicalis was the most common isolate, and the most common first-line treatment was antifungal agent combinations. Following factors were noted to be significantly linked with 7-day mortality: septic shock, central venous catheter removal, and granulocyte recovery; the latter 2 remained independent predictors of 30-day mortality. Mortality may reduce with prompt and adequate antifungal treatment with catheter removal.