CANDIDA-TROPICALIS INFECTIONS IN CHILDREN WITH LEUKEMIA

被引：26

作者：

FLYNN, PM

MARINA, NM

RIVERA, GK

HUGHES, WT

机构：

[1] Departments of Infectious Diseases and Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN

[2] Department of Pediatrics, University of Tennessee, Memphis, TN

来源：

LEUKEMIA & LYMPHOMA | 1993年 / 10卷 / 4-5期

关键词：

CANDIDA-TROPICALIS; FUNGEMIA; MENINGITIS; FUNGAL INFECTION; IMMUNOSUPPRESSION;

D O I：

10.3109/10428199309148562

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The Candida species account for approximately three-fourths of fungal infections in patients with cancer. Although Candida albicans is the most frequent cause, C. tropicalis is increasingly implicated as an important pathogen. Over a 12 year period 19 children treated for leukemia at our institution developed C. tropicalis infections. We describe their clinical presentation, extent of fungal infection, treatment, and outcome. Fungemia without meningitis in 11 children was treated successfully, whereas C. tropicalis meningitis in 7 children was uniformly fatal. An additional patient had unsuspected, widespread infection detected at autopsy. Multiple sites, including the cerebrospinal fluid yielded C. tropicalis. Previously reported risk factors including neutropenia, broad-spectrum antibiotic usage, corticosteroid therapy, and total parenteral nutrition were observed in our cases. A high index of suspicion and the early use of aggressive antifungal therapy are critical to the successful management of C. tropicalis infections in children with leukemia.

引用

页码：369 / 376

页数：8

共 20 条

[1]

Hart P.D., Russell E., Remington J.S., The compromised host and infection. II. Deep fungal infection, J. Infect. Dis., 120, pp. 169-191, (1969)

[2]

Bodey G.P., Fungal infection and fever of unknown origin in neutropenia patients, Am. J. Med., 80, pp. 112-119, (1986)

[3]

Krick J.A., Remington J.S., Opportunistic invasive fungal infection in patients with leukemia and lym-phoma, Clin. Hematol., 5, pp. 249-310, (1976)

[4]

Edwards J.E., Lehrer R.I., Stiehm E.R., Fischer T.J., Young L.S., Severe candidal infections: clinical perspective, immune defense mechanisms, and current concepts of therapy, Ann. Int. Med., 89, pp. 91-106, (1978)

[5]

McGowan J.E., Etiology of nosocomial bacteremia and fungemia and other hospital-acquired infections, Rev. Infect. Dis., 7, pp. S357-S370, (1985)

[6]

Meunier-Carpentier F., Kiehn T.E., Armstrong D., Fungemia in the immunocompromised host: changing patterns, antigenemia, high mortality, Am. J. Med., 71, pp. 363-370, (1981)

[7]

Horn R., Wang B., Kiehn T.E., Armstrong D., Fungemia in a cancer hospital: changing frequency, earlier onset, and results of therapy, Rev. Infect. Dis., 7, pp. 646-655, (1985)

[8]

Wingard J.R., Merz W.G., Saral R., Candida tropicalis: a major pathogen in immunocompromised patients, Ann. Int. Med., 91, pp. 539-543, (1979)

[9]

Marina N.M., Flynn P.M., Rivera G.K., Hughes W.T., Candida tropicalis and Candida albicans fungemia in children with leukemia, Cancer, 68, pp. 594-599, (1991)

[10]

Sugar A.M., Stevens D.A., Candida rugosa in immunocompromised infection, Cancer, 56, pp. 318-320, (1985)

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