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fungal infection and neutropenia

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https://www.readbyqxmd.com/read/28636889/complications-of-hematopoietic-stem-transplantation-fungal-infections
#1
REVIEW
Ali S Omrani, Reem S Almaghrabi
Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk of invasive fungal infections, especially during the early neutropenic phase and severe graft-versus-host disease. Mold-active prophylaxis should be limited to the highest risk groups. Empiric antifungal therapy for HSCT with persistent febrile neutropenia is associated with unacceptable response rates, unnecessary antifungal therapy, increased risk of toxicity, and inflated costs. Empiric therapy should not be a substitute for detailed work up to identify the cause of fever in such patients...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28622118/imaging-spectrum-of-invasive-fungal-and-fungal-like-infections
#2
Hilary L P Orlowski, Sebastian McWilliams, Vincent M Mellnick, Sanjeev Bhalla, Meghan G Lubner, Perry J Pickhardt, Christine O Menias
Invasive fungal and fungal-like infections contribute to substantial morbidity and mortality in immunocompromised individuals. The incidence of these infections is increasing-largely because of rising numbers of immunocompromised patients, including those with neutropenia, human immunodeficiency virus, chronic immunosuppression, indwelling prostheses, burns, and diabetes mellitus, and those taking broad-spectrum antibiotics. Invasive fungal pathogens include primary mycotic organisms such as Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, and Paracoccidioides brasiliensis, which are true pathogens and inherently virulent...
June 16, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28597476/safe-fluoroquinolones-prophylaxis-in-blood-cancer-patients-with-chemotherapy-induced-neutropenia-and-glucose-6-phosphate-dehydrogenase-deficiency
#3
M Sanna, G Caocci, F Orrù, A Ledda, A Vacca, E Piras, C Fozza, P Deias, G Tidore, F Dore, G La Nasa
WHAT IS KNOWN AND OBJECTIVE: Bacterial infections are the leading causes of morbidity and mortality in haematologic patients with chemotherapy-induced neutropenia. The only strategy shown to be effective in reducing febrile neutropenia incidence is fluoroquinolone prophylaxis, but the safety of this class of drugs in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD-), the most common human enzyme defect, is still controversial because of the claimed association with acute haemolytic anaemia...
June 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28574735/fatal-course-of-saprochaete-capitata-fungemia-in-children-with-acute-lymphoblastic-leukemia
#4
Zeynep Canan Özdemir, Ayşe Bozkurt Turhan, Yeter Düzenli Kar, Çağrı Ener Dinleyici, Özcan Bör
Saprochaete capitata (S. capitata) is a very rare fungal pathogen that causes disseminated opportunistic infections in patients with hematologic malignancies. Fever resistant to broad-spectrum antibiotic and antifungal treatment is common in the presence of fungemia during the period of profound neutropenia. We describe three cases of leukemic children who died from S. capitata fungemia following a first febrile neutropenic episode after the induction of chemotherapy. S. capitata fungemia is an emergent infection associated with high mortality and low susceptibility to fluconazole and echinocandins...
June 2, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/28556426/retrospective-study-on-the-incidence-and-outcome-of-proven-and-probable-invasive-fungal-infections-in-high-risk-pediatric-onco-hematological-patients
#5
Simone Cesaro, Gloria Tridello, Elio Castagnola, Elisabetta Calore, Francesca Carraro, Ilaria Mariotti, Antonella Colombini, Katia Perruccio, Nunzia Decembrino, Giovanna Russo, Natalia Maximova, Valentina Baretta, Désirée Caselli
BACKGROUND: invasive fungal infection (IFI) is a cause of morbidity, mortality and increased health costs in children undergoing chemotherapy or hematopoietic stem cell transplant (HSCT). METHODS: multi-center, retrospective study to assess the incidence, outcome of proven and probable IFI (PP-IFI) in children treated for acute leukemia, non-Hodgkin lymphoma or who underwent HSCT from 2006 to 2012. RESULTS: Over the 7-year period, 127 PP-IFI were diagnosed in 123 patients, median age of 9...
May 27, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28510690/trichosporonosis-in-pediatric-patients-with-a-hematologic-disorder
#6
Catherine E Foster, Morven S Edwards, Julienne Brackett, Deborah A Schady, C Mary Healy, Carol J Baker
Background.: Trichosporonosis is an emerging and often fatal opportunistic fungal infection in immunocompromised patients, particularly those with hematologic malignancy, but data in children are lacking. Methods.: We report here 3 cases of invasive infection caused by Trichosporon asahii in pediatric patients with acute lymphoblastic leukemia at Texas Children's Hospital in Houston, Texas. We also conducted a literature review and identified 16 additional reports of pediatric patients with invasive T asahii infection and an underlying malignant or nonmalignant hematologic disorder...
May 16, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28444360/role-of-early-onset-neutropenia-in-development-of-candidemia-in-premature-infants
#7
Nermin Ramy, Mohamed Hashim, Heba Abou Hussein, Happy Sawires, Maha Gaafar, Ayat El Maghraby
Background: The aim of the study was to assess the effect of early-onset neutropenia (EON) on the development of candidemia in premature infants and evaluate other risk factors. Materials and Methods: This prospective study was carried out in a neonatal intensive care unit of Cairo University Hospital. Fifty neutropenic premature infants were matched to 50 non-neutropenics. Subjects were then regrouped into candidemics and non-candidemics to study other risk factors such as central venous catheters, mechanical ventilation, parenteral nutrition, drugs as corticosteroids and others...
April 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28429246/comparison-of-efficacy-and-safety-of-caspofungin-versus-micafungin-in-pediatric-allogeneic-stem-cell-transplant-recipients-a-retrospective-analysis
#8
Natalia Maximova, Giulia Schillani, Roberto Simeone, Alessandra Maestro, Davide Zanon
INTRODUCTION: The high morbidity and mortality associated with invasive fungal infections (IFIs) provide the rationale for antifungal prophylaxis in immuno-compromised pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Caspofungin and micafungin are antifungal agents of interest for prophylaxis of IFIs because of their potency against Candida and minimal toxicity or interactions with other drugs. Few studies have demonstrated the safety and efficacy of such echinocandins as prophylaxis for IFIs in patients undergoing HSCT...
May 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28426102/infection-related-complications-during-treatment-for-childhood-acute-lymphoblastic-leukemia
#9
H Inaba, D Pei, J Wolf, S C Howard, R T Hayden, M Go, O Varechtchouk, T Hahn, J Buaboonnam, M L Metzger, J E Rubnitz, R C Ribeiro, J T Sandlund, S Jeha, C Cheng, W E Evans, M V Relling, C-H Pui
Background: Comprehensive studies on neutropenia and infection-related complications in patients with acute lymphoblastic leukemia (ALL) are lacking. Patients and methods: We evaluated infection-related complications that were grade ≥3 on National Cancer Institute's Common Terminology Criteria for Adverse Events (version 3.0) and their risk factors in 409 children with newly diagnosed ALL throughout the treatment period. Results: Of the 2420 infection episodes, febrile neutropenia and clinically or microbiologically documented infection were seen in 1107 and 1313 episodes, respectively...
February 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28417421/a-review-of-infectious-complications-after-haploidentical-hematopoietic-stem-cell-transplantations
#10
REVIEW
Erden Atilla, Pinar Ataca Atilla, Sinem Civriz Bozdağ, Taner Demirer
BACKGROUND: Allogeneic hematopoietic stem cell transplantation from haploidentical donor is a feasible option for patients with hematological diseases who lack a suitable HLA-matched donor, but viral and fungal infections are still the most common causes of morbidity and mortality in haploidentical transplantation setting because of delayed immune reconstitution, increased risk of graft vs host disease (GvHD) or systemic steroid use. Therefore, this review will focus on the infectious complications after haploidentical hematopoietic stem cell transplantation (HSCT)...
April 17, 2017: Infection
https://www.readbyqxmd.com/read/28413792/epedimiologic-clinical-profile-and-factors-affecting-the-outcome-in-febrile-neutropenia
#11
Kalpathi Krishnamani, Linga Vijay Gandhi, Gundeti Sadashivudu, Digumarti Raghunadharao
BACKGROUND: Febrile neutropenia (FN) is common in cancer patients particularly hematologic malignancies due to intensive cytotoxic chemotherapy. It is an important cause of morbidity, mortality and treatment delays. The risk is greater in patients with ANC < 500/ mm3 and increases dramatically in those with ANC < 100/ mm3 and duration of neutropenia more than 1 week. AIMS AND OBJECTIVES: The purpose of this study was to evaluate the incidence, demographic characteristics, clinical profile, mortality, outcome and factors affecting the outcome in patients with febrile neutropenia (FN) admitted at our Center between January 2011 and November 2012...
January 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28363097/gastrointestinal-emergencies-in-critically-ill-cancer-patients
#12
Delphine Lebon, Lucie Biard, Sophie Buyse, David Schnell, Etienne Lengliné, Camille Roussel, Jean-Marc Gornet, Nicolas Munoz-Bongrand, Laurent Quéro, Matthieu Resche-Rigon, Elie Azoulay, Emmanuel Canet
PURPOSE: To describe gastrointestinal emergencies in cancer patients. METHODS: All cancer patients admitted to the medical ICU of Saint-Louis Hospital for an acute abdominal syndrome during the study period (1997-2011) were included. RESULTS: A total of 164 patients were included. The most common diagnoses were: neutropenic enterocolitis (NE) (n=54, 33%), infectious colitis and peritonitis (n=51, 31%), bowel infiltration by malignancy (n=14, 9%), and mucosal toxicity of chemotherapy (n=12, 7%)...
March 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28355465/clinical-considerations-in-the-early-treatment-of-invasive-mould-infections-and-disease
#13
Toine Mercier, Johan Maertens
Different therapeutic strategies for invasive fungal diseases have been explored, each with particular strengths and weaknesses. Broad-spectrum antifungal prophylaxis seems logical, but selective use is important due to its substantial disadvantages, including interference with diagnostic assays, selection for resistance, drug toxicity and drug-drug interactions. Antimould prophylaxis should be restricted to high-risk groups, such as patients undergoing intensive chemotherapy for acute myeloid leukaemia or myelodysplastic syndrome, allogeneic HSCT patients with prior invasive fungal infection, graft-versus-host-disease or extended neutropenia, recipients of a solid organ transplant, or patients with a high-risk inherited immunodeficiency...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28344057/ruxolitinib-as-salvage-therapy-in-steroid-refractory-acute-graft-versus-host-disease-in-pediatric-hematopoietic-stem-cell-transplant-patients
#14
Pooja Khandelwal, Ashley Teusink-Cross, Stella M Davies, Adam S Nelson, Christopher E Dandoy, Javier El-Bietar, Rebecca A Marsh, Ashish R Kumar, Michael S Grimley, Sonata Jodele, Kasiani C Myers
We describe our retrospective clinical experience with ruxolitinib for steroid-refractory acute graft-versus-host disease (GVHD) in pediatric allogeneic hematopoietic stem cell transplant (HSCT) patients. Ruxolitinib was administered orally at 5 mg twice daily for children ≥ 25 kg or 2.5 mg twice daily if <25 kg. We excluded patients who received new immune suppressive agents within 2 weeks before initiation of ruxolitinib from response analysis. Patients were called a treatment failure if ruxolitinib was stopped before completion of 4 weeks of therapy because of adverse effects and not because of progression of acute GVHD...
March 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28340200/cytokines-profile-in-immunocompetent-mice-during-trichosporon-asahii-infection
#15
Alexandra M Montoya, Gloria M González, Azalia M Martinez-Castilla, Sonia A Aguilar, Moises A Franco-Molina, Erika Coronado-Cerda, Adrián G Rosas-Taraco
Trichosporon asahii is an opportunistic yeastlike fungus commonly associated with systemic infections in immunocompromised patients. Neutropenia is recognized as the main risk factor in infections by T. asahii; however, little is known about the cytokine response during trichosporonosis. Here, we evaluated systemic and local cytokine production and histological damage in immunocompetent mice during systemic infection with T. asahii. We found a significant increased presence of G-CSF, TNF-α, IFN-γ, and IL-6 in sera samples...
March 15, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28321926/evaluation-of-30-cases-of-mucormycosis-at-a-university-hospital-in-iran
#16
Reza Samarei, Naser Gharebaghi, Salar Zayer
Mucormycosis is a deadly invasive fungal infection and mainly affects immunocompromised patients. To investigate the clinical features of patients who developed mucormycosis and to determine the parameters, which influenced the outcome following mycotic infection. The current investigation retrospectively evaluated the demographic characteristics, clinical features, therapeutic data, as well as the outcomes of treatment in all cases of proven and probable mucormycosis diagnosed from 2002 until 2016 in our hospital...
March 20, 2017: Mycoses
https://www.readbyqxmd.com/read/28295178/granulocyte-transfusions-in-the-management-of-invasive-fungal-infections
#17
REVIEW
Kamille A West, Juan Gea-Banacloche, David Stroncek, Sameer S Kadri
Granulocyte transfusions have a long history of being used in patients with neutropenia or neutrophil dysfunction to prevent and treat invasive fungal infections. However, there are limited and conflicting data concerning its clinical effectiveness, considerable variations in current granulocyte transfusion practices, and uncertainties about its benefit as an adjunct to modern antifungal therapy. In this review, we provide an overview on granulocyte transfusions and summarize the evidence on their role in the prevention and treatment of invasive fungal infections...
May 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28270852/effects-of-honey-on-oral-mucositis-among-pediatric-cancer-patients-undergoing-chemo-radiotherapy-treatment-at-king-abdulaziz-university-hospital-in-jeddah-kingdom-of-saudi-arabia
#18
Soad K Al Jaouni, Mohammad S Al Muhayawi, Abear Hussein, Iman Elfiki, Rajaa Al-Raddadi, Saad M Al Muhayawi, Saad Almasaudi, Mohammad Amjad Kamal, Steve Harakeh
One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28243106/ruxolitinib-in-myelofibrosis-to-be-or-not-to-be-an-immune-disruptor
#19
Palma Manduzio
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm classified according to the 2016 revision of World Health Organization Classification of Tumors and Haematopoietic and Lymphoid Tissue. Ruxolitinib is an oral inhibitor of Janus kinase approved in the USA for the treatment of intermediate or high-risk PMF and approved in Europe for the treatment of splenomegaly and constitutional symptoms of the disease. More recently, case reports described serious opportunistic infections in this neoplasm treated with ruxolitinib...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28231567/innate-lung-defense-during-invasive-aspergillosis-new-mechanisms
#20
Jaleesa M Garth, Chad Steele
Invasive aspergillosis (IA) is one of the most difficult to treat and, consequently, one of the most lethal fungal infections known to man. Continued use of immunosuppressive agents during chemotherapy and organ transplantation often leads to the development of neutropenia, the primary risk factor for IA. However, IA is also becoming more appreciated in chronic diseases associated with corticosteroid therapy. The innate immune response to Aspergillus fumigatus, the primary agent in IA, plays a pivotal role in the recognition and elimination of organisms from the pulmonary system...
2017: Journal of Innate Immunity
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