Risk Factors Associated With Invasive Fungal Disease in Children With Cancer and Febrile Neutropenia

Abstract

Fever persisting at day 4 of admission, together with AMC < or =100 and CRP > or =90 significantly increased the risk for IFD in children with cancer.

Invasive Fungal Infections in Children With Hematologic and Malignant Diseases

“…The incidence of IFIs in these studies is between 4.9% and 7.2%, similar to our study. 1,2,10,11 The diagnosis of IFI and the detection of the etiological pathogen are very difficult in children. Histopathologic studies and microbial growth in proper samples are important in the diagnosis of the disease; however, invasive interventions such as biopsy are generally not applicable in these patients due to frequent thrombocytopenia and risk of bleeding complication.…”

“…Maintenance therapies were defined as nonintensive treatments. 2 Deaths seen within the first month of fungal infections was defined as IFI-related mortality.…”

“…In this patient group, the incidence of IFI has increased due to aggressive chemotherapeutic and immunosuppressive therapy regimens, severe mucositis, deep and prolonged neutropenia, and usage of wide-spectrum antibiotics or steroids. [1][2][3][4] IFIs are most frequently developed in relation to the Candida and Aspergillus strains. The spectrum of invasive candidiasis (IC) may vary from catheter-related candidemia to single-organ involvement or disseminated infections, and the mortality of IC may be as high as 31% in children.…”

Caracterización de los episodios de neutropenia febril en niños con leucemia mieloide aguda y leucemia linfoblástica aguda

“…La frecuencia de IFI encontradas en pacientes con LMA (4,6%) fue similar a la encontrada en estudios nacionales previos (5,8%), que involucraban todos los episodios de NF, incluyendo IFI probadas, probable y posibles 12 , estas últimas excluidas de este análisis. Destacó además el amplio uso de antifúngicos en los episodios de NF en niños con LMA, la mayor parte de tipo empírico, esto debido a la mayor duración de fiebre y neutropenia, lo cual condujo, siguiendo recomendaciones internacionales 10,13 , a adicionar terapia empírica antifúngica después del 4° día de evolución desfavorable en niños con NF.…”

Risk of serious bloodstream infections is low in pediatric hematopoietic stem cell transplant (HSCT) recipients with fevers due to antithymocyte globulins and alemtuzumab

“…9 There were two true BSI among 14 patients with an ANC o500/μL at the time of ST-related fever (14% (95% CI 4 − 40%)), which is similar to the 10 − 20% rate of BSI described in neutropenic oncology patients with a new onset of fever. 10,11 Regardless of the ANC at the start of ST, the majority of organisms identified as causing BSI in patients receiving ST were of low virulence, dominated by CNS, which is also a common BC contaminant.…”