Respiratory Viral Infections in Children With Leukemia

Koskenvuo, Minna; Möttönen, Merja; Rahiala, Jaana; Saarinen‐Pihkala, Ulla M.; Riikonen, Pekka; Waris, Matti; Ziegler, Thedi; Uhari, Matti; Salmi, Toivo T.; Ruuskanen, Olli

doi:10.1097/inf.0b013e31817b0799

Cited by 76 publications

(117 citation statements)

References 51 publications

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“…In addition, caspofungin has also been tried as salvage in patients with resistant fungal infections. Possibility that few of these pulmonary infiltrates might be due to viral infections cannot be ruled out [40]. Detailed virology work up was not done due to lack of facilities.…”

Section: Discussionmentioning

confidence: 99%

Infections in acute myeloid leukemia: an analysis of 382 febrile episodes

Gupta

Singh

et al. 2009

Med Oncol

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Neutropenic fever is an important cause of morbidity and mortality during therapy of acute myeloid leukemia (AML). We retrospectively analyzed 382 febrile episodes encountered during induction and consolidation chemotherapy to determine the potential etiology, microbiologic spectrum, response/resistance to antibiotics and outcome. Between May, 2001 and December, 2006, 95 patients with de novo non-M3 AML received remission induction chemotherapy followed by consolidation in those who achieved complete remission. Patients median age was 28 years, ranging from 2 to 61 years, 26 patients were ≤15 years of age. There were 57 males and 38 females. Febrile neutropenia was defined as per international guidelines. A total of 382 febrile episodes were recorded; neutropenic 347 (induction phase 172, consolidation phase 175) and non-neutropenic 35 (induction 16, consolidation 19). Clinical, microbiological and radiological evidence of infection could be identified in 64% of the febrile episodes (74% during induction, 52% during consolidation). Pulmonary infections were most common, both during induction and consolidation phase. Microbiologically gram-negative infections predominated. There were 60 possible/probable/definite episodes of fungal infection. Six cases of tuberculosis (pulmonary 5 and spine 1) and 3 cases of malaria (including one case of cerebral malaria) were also identified. Nineteen patients died (17 during induction, 2 during consolidation); 17 deaths were infection related, 12/17 possibly due to fungal infections. We suggest that evaluation of antibacterial resistance patterns in an institution must be done routinely in order to choose empiric antibiotics therapy. Careful selection of antibiotics and early institution of antifungal therapy besides considering alternative diagnosis peculiar to the region (e.g. tuberculosis, malaria) may help in reducing morbidity and mortality during AML therapy.

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Section: Discussionmentioning

confidence: 99%

Infections in acute myeloid leukemia: an analysis of 382 febrile episodes

Gupta

Singh

et al. 2009

Med Oncol

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“…6 Using conventional and molecular techniques, respiratory syncytial virus (RSV), rhinovirus, parainfluenza and adenovirus have been the most frequently detected viruses in patients with cancer and fever ranging in frequency from 5% to 44%. 6,9,10 Arola et al 6 reported RVI in 37% of 75 febrile episodes occurring in 32 children with cancer using viral culture, antigen detection and serology. Implementation of gene amplification−based techniques has significantly improved our capacity to detect RVs in patients with cancer, including the detection of new and/or less common viruses such as bocaviruses, metapneumovirus, coronavirus and others, and occurrence of coinfections with >1 RV.…”

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confidence: 98%

“…Implementation of gene amplification−based techniques has significantly improved our capacity to detect RVs in patients with cancer, including the detection of new and/or less common viruses such as bocaviruses, metapneumovirus, coronavirus and others, and occurrence of coinfections with >1 RV. [9][10][11] For example, Koskenvuo et al 9 identified RVI in 44% of 138 febrile episodes occurring in children with leukemia by viral culture, antigen detection and polymerase chain reaction (PCR). In this series, rhinovirus (22%) followed by RSV (11%) were most common and 9% of episodes resulted positive for >1 virus.…”

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confidence: 98%

Frequency and Clinical Outcome of Respiratory Viral Infections and Mixed Viral-bacterial Infections in Children With Cancer, Fever and Neutropenia

Torres¹,

Labraña

Ibáñez

et al. 2012

Pediatric Infectious Disease Journal

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RVIs were the most frequently detected agents irrespective of their initial risk assessment for IBI. The clinical outcome of mixed RVI was similar to sole RVI episodes as well as for bacterial infections compared with mixed viral-bacterial infections. Systematic and early detection of RVI in children with cancer and FN might help to optimize their management by reducing hospitalization and antimicrobial use.

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“…[1][2][3][4] This is strictly related to the demonstration or at least strong supposition that influenza can have a severe course or be complicated by superimposed bacterial infections in subjects with an underlying severe illness. [1][2][3][4] Children with neoplastic disease are included among those considered to be at risk because cancer and anti-cancer therapies impair immune function, thus making them more vulnerable to a variety of pathogens including influenza viruses, [5][6][7][8][9] which have a…”

Section: Introductionmentioning

confidence: 99%