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fungal infection and neutropenia

Aaron Smith, Vikrum Thimmappa, Brandon Shepherd, Meredith Ray, Anthony Sheyn, Jerome Thompson
BACKGROUND: Invasive fungal sinusitis (IFS) represents an often fatal condition within the pediatric population. In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. METHODS: We systematically reviewed EMBASE, Medline, TRIPdatabase, SCOPUS and the Cochrane database for invasive fungal nasal and sinus infections limited to individuals <18 years of age. Case series including 3 or more patients were included...
November 2016: International Journal of Pediatric Otorhinolaryngology
Maurizio Bernasconi, Alessio Casutt, Angela Koutsokera, Igor Letovanec, Frédéric Tissot, Laurent P Nicod, Alban Lovis
The role of radial-endobronchial ultrasound (R-EBUS) assisted transbronchial biopsy (TBB) for the diagnosis of peripheral pulmonary lesions is well established. However, no study has addressed its safety and value in hemato-oncological patients presenting with non-resolving infiltrates during persistent febrile neutropenia. To assess safety and feasibility of R-EBUS assisted TBB in severe thrombocytopenic and neutropenic patients. Over a period of 18 months, eight patients were assessed with R-EBUS assisted TBB after adequate platelet transfusion...
October 4, 2016: Lung
Stephen A Klotz, Richard E Sobonya, Peter N Lipke, Melissa C Garcia-Sherman
It is a striking observation that tissue of patients invaded by the deep mycoses often lacks evidence of an inflammatory response. This lack of host response is often attributed to neutropenia secondary to chemotherapy. However, systematic studies do not support this simplistic explanation. However, invasive fungal lesions are characterized by abundant fungal functional amyloid, which in turn is bound by serum amyloid P component (SAP). We postulate that SAP is important in the local immune response in invasive fungal infections...
September 2016: Open Forum Infectious Diseases
Michaela Döring, Karin Melanie Cabanillas Stanchi, Hartwig Klinker, Melinda Eikemeier, Judith Feucht, Franziska Blaeschke, Carl-Philipp Schwarze, Martin Ebinger, Tobias Feuchtinger, Rupert Handgretinger, Werner J Heinz
Invasive fungal infections are one of the major complications in pediatric patients during prolonged neutropenia after chemotherapy. Evaluation of the efficacy and safety of the triazole posaconazole in these patients is missing. This multicenter survey analyzed trough concentrations of 33 pediatric patients with a median age of 8 years during 108 neutropenic episodes who received prophylactic posaconazole oral suspension. A total of 172 posaconazole trough levels were determined to median 438 ng/ml (range 111-2011 ng/ml; mean 468 ± 244 ng/ml)...
October 4, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Heidrun Boztug, Nora Mühlegger, Ulrike Pötschger, Andishe Attarbaschi, Christina Peters, Georg Mann, Michael Dworzak
Intensive chemotherapy directed against acute myeloid leukemia of childhood is followed by profound neutropenia and high risk for bacterial and fungal infections, including viridans group streptococci as a common cause for gram-positive septicemia. Few retrospective studies have shown the efficacy of various antibiotic prophylactic regimens in children. We retrospectively studied 50 pediatric patients treated on the AML-BFM 2004 protocol between 2005 and 2015 at St. Anna Children's Hospital and assessed the effect of antibiotic prophylaxis on the frequency of febrile neutropenia and bacterial sepsis...
October 4, 2016: Annals of Hematology
Alina Tanase, Anca Colita, Gabriel Ianosi, Daniela Neagoe, Daciana Elena Branisteanu, Daniela Calina, Anca Oana Docea, Aristidis Tsatsakis, Simona Laura Ianosi
Fusarium infection is a severe fungal infection caused by fungi of the genus Fusarium. It most commonly occurs in immunocompromised patients with malignant hematological comorbidities or secondary to hematopoietic stem cell transplant. The classical route of contamination is through inhalation but infection may also occur through contiguity with a skin lesion. This report describes the case of a 24-year-old woman who developed graft-vs.-host disease (GVHD) at 220 days after receiving an allogeneic stem cell transplant from a sibling donor for Hodgkin disease...
October 2016: Experimental and Therapeutic Medicine
Kotaro Miyao, Masashi Sawa, Mio Kurata, Ritsuro Suzuki, Reona Sakemura, Toshiyasu Sakai, Tomonori Kato, Satomi Sahashi, Natsuko Tsushita, Yukiyasu Ozawa, Motohiro Tsuzuki, Akio Kohno, Tatsuya Adachi, Keisuke Watanabe, Kaneyuki Ohbayashi, Yuichiro Inagaki, Yoshiko Atsuta, Nobuhiko Emi
Invasive fungal infection (IFI) is a major life-threatening problem encountered by patients with hematological malignancies receiving intensive chemotherapy. Empirical antifungal agents are therefore important. Despite the availability of antifungal agents for such situations, the optimal agents and administration methods remain unclear. We conducted a prospective phase 2 study of empirical 1 mg/kg/day liposomal amphotericin B (L-AMB) in 80 patients receiving intensive chemotherapy for hematological malignancies...
September 30, 2016: International Journal of Hematology
Livio Pagano, Alessandro Busca, Anna Candoni, Chiara Cattaneo, Simone Cesaro, Rosa Fanci, Gianpaolo Nadali, Leonardo Potenza, Domenico Russo, Mario Tumbarello, Annamaria Nosari, Franco Aversa
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in immunocompromised patients. Patients with hematological malignancies undergoing conventional chemotherapy, autologous or allogeneic hematopoietic stem cell transplantation are considered at high risk, and Aspergillus spp. represents the most frequently isolated micro-organisms. In the last years, attention has also been focused on other rare molds (e.g., Zygomycetes, Fusarium spp.) responsible for devastating clinical manifestations...
September 17, 2016: Blood Reviews
Janaki Vallipuram, Sidika Dhalla, Chaim M Bell, Linda Dresser, Heekyung Han, Shahid Husain, Mark D Minden, Narinder S Paul, Miranda So, Marilyn Steinberg, Mayuran Vallipuram, Gary Wong, Andrew M Morris
Chest computed tomography (CT) findings of nodules, ground glass opacities, and consolidations are often interpreted as representing invasive fungal infection in individuals with febrile neutropenia. We assessed whether these CT findings were present in asymptomatic individuals with acute myeloid leukemia (AML) at low risk of invasive fungal disease. A retrospective study of consecutive asymptomatic adult patients with newly diagnosed AML over a 2-year period was performed at a tertiary care oncology center...
September 19, 2016: Leukemia & Lymphoma
Lucía Martínez-Hernández, Diana Vilar-Compte, Patricia Cornejo-Juárez, Patricia Volkow-Fernández
INTRODUCTION: Nosocomial pneumonia (NP) in patients with hematological malignancies (HM) has an attributable mortality over 90%. There are few studies that report the incidence of nosocomial infections in patients with HM. OBJECTIVE: To describe the epidemiology and clinical course of NP in a cohort of patients with hematologic malignancies. MATERIAL AND METHODS: Single-center study of patients with leukemia, lymphoma or multiple myeloma diagnosed with NP, hospitalized between January 2011 and December 2012...
July 2016: Gaceta Médica de México
Abraham Yacoub, Kiran K Soni, Lysenia Mojica, Jane Mai, Jamie Morano, C Wayne Cruse, Ramon L Sandin, Sowmya Nanjappa, Chandrashekar Bohra, Ganesh Gajanan, John N Greene
BACKGROUND: Opportunistic fungal infections caused by Aspergillus and Candida followed by infections with Fusarium, Rhizopus, Mucor, and Alternaria species are an important cause of morbidity and mortality in patients with hematological malignancies. Cutaneous mucormycosis infections are rare, and the incidence, outcomes, and factors associated with survival in the setting of hematological malignancies are not clear. METHODS: A literature search was conducted for all cases of primary cutaneous mold infections in patients with hematological malignancy, of which 50 cases were found...
July 2016: Cancer Control: Journal of the Moffitt Cancer Center
Nihal Özdemir, Gülen Tüysüz, Nigar Çelik, Leman Yantri, Ethem Erginöz, Hilmi Apak, Alp Özkan, İnci Yıldız, Tiraje Celkan
AIM: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. MATERIAL AND METHODS: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study...
June 2016: Türk Pediatri Arşivi
Luciana Teofili, Caterina Giovanna Valentini, Roberta Di Blasi, Nicoletta Orlando, Luana Fianchi, Gina Zini, Simona Sica, Valerio De Stefano, Livio Pagano
It is still under debate whether granulocyte transfusions (GTs) substantially increase survival in patients with febrile neutropenia. We retrospectively examined data relative to 96 patients with hematological malignancies receiving 491 GTs during 114 infectious episodes (IE). Patients were grouped according to the median doses of granulocytes transfused during the infectious episode (low-dose group: <1.5-x108 cells/Kg; standard-dose group: 1.5-3.0x108 cells/Kg and high-dose group: >3.0x108 cells/Kg)...
2016: PloS One
José Moreira, Felipe Ridolfi, Rodrigo Almeida-Paes, Andrea Varon, Cristiane C Lamas
Angionvasive mucormycosis is an emerging fungal disease known to affect mainly diabetics or subjects with profound neutropenia. Infection usually occurs through the inhalation route, but cutaneous inoculation may occur after trauma or burns. However, mucormycosis remains unusual in HIV infection. We report a fatal case of cutaneous mucormycosis due to Rhizopus arrhizus involving the scalp following herpes zoster infection. The patient was a 42-year-old man with advanced AIDS failing on salvage antiretroviral therapy...
July 26, 2016: Brazilian Journal of Infectious Diseases
Karina Colossi Furlan, Mario Cezar Pires, Priscila Kakizaki, Juliana Cabral Nunes Chartuni, Neusa Yuriko Sakai Valente
We describe the case of a 9-year-old boy with idiopathic bone marrow aplasia and severe neutropenia, who developed skin ulcers under cardiac monitoring electrodes. The diagnosis of primary cutaneous aspergillosis was made after the second biopsy and culture. Imaging investigation did not reveal internal fungal infection. The child was treated, but did not improve and died 3 months after admission. The report highlights and discusses the preventable risk of aspergillus skin infection in immunocompromised patients...
May 2016: Anais Brasileiros de Dermatologia
Jun-Hyung Lee, Jin-Soo Hyun, Da-Yeong Kang, Hee-Jeong Lee, Sang-Gon Park
BACKGROUND: Mucormycosis is a rare and life-threatening invasive fungal infection. Pulmonary mucormycosis commonly occurs in patients with severe neutropenia. Typically, pulmonary mucormycosis causes tissue necrosis resulting from angioinvasion and subsequent thrombosis, so most cases can occur with necrotizing pneumonia and/or hemoptysis. Some complex cases may invade adjacent organs, such as the mediastinum, pericardium, and chest wall. However, to the best our knowledge there is little known regarding bronchoesophageal fistula due to pulmonary mucormycosis after induction chemotherapy for acute myeloid leukemia...
2016: Journal of Medical Case Reports
Domenico Albano, Giovanni Bosio, Mattia Bertoli, Giulia Petrilli, Francesco Bertagna
Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography ((18)F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature...
2016: Asia Ocean J Nucl Med Biol
Weiye Nie, Qin Huang, Yongsheng Chen, Xiaolin Yin
Invasive aspergillosis infection (IF) in patients with hematologic malignancies is common. Prognosis of IF in patients with acute myeloid leukemia (AML) not responsive to chemotherapy is very poor, especially when neutropenia is duration. Fractional HLA haplo-identical mobilized neutropenia peripheral blood stem cell (PBSC) transfusion, which was defined as micro-transplantation, was recently adopted in treatment of elder patients with AML and shown to be effective in fasting hemopoiesis recovery. Here we report the outcome of an elderly patient with AML accompanying IF treated with microtransplantation and voriconazole...
June 2016: Indian Journal of Hematology & Blood Transfusion
Kamal Kant Sahu, Uday Yanamandra, Rishi Dhawan, Alka Khadwal, S S Dhandapani, Pankaj Malhotra
We report a case of a 15-year old boy who was managed as a case of B cell lymphoblastic leukaemia with the modified BFM 90 protocol. During the induction phase, he developed febrile neutropenia with sino-pulmonary fungal infection confirmed on histopathology. He developed left sided hemiparesis during in-hospital management of febrile neutropenia. Neuroimaging revealed 9.6 × 8.4 mm round well defined aneurysm arising from right cortical artery in distal middle cerebral artery territory. He underwent fronto-temporo-parietal craniectomy with evacuation of the hematoma and excision of the aneurysm...
June 2016: Indian Journal of Hematology & Blood Transfusion
Won-Tak Choi, Tammy T Chang, Ryan M Gill
Zygomycosis is a rare invasive opportunistic fungal infection that occurs in the setting of hematologic malignancies, chemotherapy-induced neutropenia, and immunosuppressive therapies. We report the first case of disseminated appendiceal zygomycosis due to Absidia spp. in a neutropenic patient who initially presented as acute appendicitis. A 63-year-old woman with acute myeloid leukemia presented as acute appendicitis while receiving induction chemotherapy and ultimately succumbed to overwhelming disseminated zygomycosis...
January 2016: Case Reports in Gastroenterology
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