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fungal infection and neutropenia

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https://www.readbyqxmd.com/read/28198173/delphi-based-study-and-analysis-of-key-risk-factors-for-invasive-fungal-infection-in-haematological-patients
#1
L Vázquez, M Salavert, J Gayoso, M Lizasoaín, I Ruiz Camps, N Di Benedetto
OBJECTIVE: Mortality caused by invasive fungal infections due to filamentous fungi (IFI-FF) is high. Predisposing factors to IFI-FF are multiple and should be stratified. The objective of this study was to identify key risk factors for IFI-FF in onco-haematological patients in different clinical settings. METHODS: Prospective national Delphi study. Risk factors for IFI-FF in patients with onco-haematological diseases were identified by a systematic review of the literature...
February 14, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28194062/performance-of-galactomannan-antigen-beta-d-glucan-and-aspergillus-lateral-flow-device-for-the-diagnosis-of-invasive-aspergillosis
#2
Gökhan Metan, Muzaffer Keklik, Gökçen Dinç, Çiğdem Pala, Afra Yıldırım, Berkay Saraymen, Mustafa Yavuz Köker, Leylagül Kaynar, Bülent Eser, Mustafa Çetin
Aspergillus lateral-flow device (LFD) was recently introduced as a practical tool for the diagnosis of invasive aspergillosis (IA). We investigated the performance of Aspergillus-LFD as a point-of-care test for the diagnosis of IA. Serum samples were collected twice weekly from patients who received intensive chemotherapy for acute leukemia, or recepients of allogeneic stem cell transplantation. Aspergillus galactomannan (GM) antigen, 1,3-beta-d-glucan and Aspergillus-LFD tests were carried out according to manufacturers' recommendations...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28179321/efficacy-and-toxicity-of-induction-therapy-with-cladribine-idarubicin-and-cytarabine-iac-for-acute-myeloid-leukemia
#3
Susan K Woelich, James T Braun, Martin W Schoen, Reshma Ramlal, Carl E Freter, Paul J Petruska, Jack M Lionberger
We report our single-center experience with cytarabine and idarubicin for induction therapy for acute myeloid leukemia (AML) with an additional 5 days of cladribine (IAC therapy). From July 2012 to September 2014, 38 patients completed a full course of IAC induction. Median patient age was 61 years, 61% of patients were ≥60 years old, and 71% were male. The complete remission (CR) rate was 63% following a single induction course, three patients (8%) required a second induction course to achieve CR, for an overall response rate of 71%...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28150341/invasive-infections-due-to-saprochaete-and-geotrichum-species-report-of-23-cases-from-the-fungiscope-registry
#4
Luisa Durán Graeff, Danila Seidel, Maria J G T Vehreschild, Axel Hamprecht, Anupma Kindo, Zdenek Racil, Judit Demeter, Sybren De Hoog, Ute Aurbach, Maren Ziegler, Hilmar Wisplinghoff, Oliver A Cornely
Saprochaete and Geotrichum spp. are rare emerging fungi causing invasive fungal diseases in immunosuppressed patients and scarce evidence is available for treatment decisions. Among 505 cases of rare IFD from the FungiScope(™) registry, we identified 23 cases of invasive infections caused by these fungi reported from 10 countries over a 12-year period. All cases were adults and previous chemotherapy with associated neutropenia was the most common co-morbidity. Fungaemia was confirmed in 14 (61%) cases and deep organ involvement included lungs, liver, spleen, central nervous system and kidneys...
February 2, 2017: Mycoses
https://www.readbyqxmd.com/read/28148470/diagnostic-accuracy-of-interleukin-6-interleukin-8-and-interleukin-10-for-predicting-bacteremia-in-children-with-febrile-neutropenia
#5
Zümrüt Şahbudak Bal, Nihal Karadaş Özdemir, Semra Şen, Deniz Yılmaz Karapınar, Elif Azarsız, Şöhret Aydemir, Fadıl Vardar
Despite improvements in diagnosis and treatment, infections are still major cause of morbidity and mortality in children with febrile neutropenia. In majority of febrile episodes, infection source cannot be defined. In this study, we aim to identify the earlier predictors of bacteremia/fungemia and a useful cytokine identify the source of infections and to discriminate the patients with culture-confirmed bacterial/fungal infection. The most sensitive cytokine was IL (Interleukin)-10 and the most specific was IL-8 in predicting culture-confirmed...
February 1, 2017: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/28114533/associations-of-antifungal-treatments-with-prevention-of-fungal-infection-in-critically-ill-patients-without-neutropenia
#6
COMMENT
Andrea Cortegiani, Vincenzo Russotto, Antonino Giarratano
Clinical Question: Are antifungal agents associated with lower rates of mortality and invasive fungal infections when administered before definitive diagnosis of an invasive fungal infection in critically ill patients without neutropenia? Bottom Line: Antifungal treatment administered prior to diagnosis of an invasive fungal infection is not associated with either higher or lower rates of all-cause mortality. Antifungal treatment in this setting is associated with lower rates of invasive fungal infections compared with placebo or no intervention in critically ill patients without neutropenia, but the quality of the evidence is low...
17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28101308/antibacterial-resistance-in-patients-with-hematopoietic-stem-cell-transplantation
#7
REVIEW
Sehnaz Alp, Murat Akova
Recipients of hematopoietic stem cell transplantation (HSCT) are at substantial risk of bacterial, fungal, viral, and parasitic infections depending on the time elapsed since transplantation, presence of graft-versus-host disease (GVHD), and the degree of immunosuppression. Infectious complications in HSCT recipients are associated with high morbidity and mortality. Bacterial infections constitute the major cause of infectious complications, especially in the early post-transplant period. The emergence of antibacterial resistance complicates the management of bacterial infections in this patient group...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28089099/clinical-characteristics-and-outcome-of-invasive-fungal-infections-in-pediatric-acute-myeloid-leukemia-patients-in-a-medical-center-in-taiwan
#8
Gu-Lung Lin, Hsiu-Hao Chang, Chun-Yi Lu, Chung-Ming Chen, Meng-Yao Lu, Ping-Ing Lee, Shiann-Tarng Jou, Yung-Li Yang, Li-Min Huang, Luan-Yin Chang
BACKGROUND: Invasive fungal infection (IFI) causes significant morbidity and mortality in patients with hematological malignancies, especially those with acute myeloid leukemia (AML), recurrent acute leukemia, high-risk acute lymphoblastic leukemia, and after allogeneic hematopoietic stem cell transplantation. The study aimed to investigate the clinical characteristics and outcome of IFIs in pediatric AML patients in a medical center in Taiwan. METHODS: We performed retrospective chart reviews...
December 19, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28027285/acute-rhinosinusitis-in-immunosuppressed-children-diagnostic-and-therapeutic-management
#9
Amit Ritter, Salvador Fischer, Eitan Yaniv, Tuvia Hadar, Ethan Soudry, Daniel Shai, Dror Gilony, Gideon Bachar
BACKGROUND: Immunosuppressive therapy places pediatric patients at risk of developing life-threatening sinonasal infections. Diagnosis and treatment is challenging owing to nonspecific signs and symptoms. The aim of the study was to present our department's experience with the surgical management of acute rhinosinusitis in immunosuppressed children. METHODS: The records of all children with a hematologic or oncologic disease who underwent endoscopic sinus surgery (ESS) for acute rhinosinusitis from January 2005 to May 2014 were reviewed...
December 23, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27943503/invasive-fungal-infection-after-heart-transplantation-a-7-year-single-center-experience
#10
Ignacio A Echenique, Michael P Angarone, Robert A Gordon, Jonathan Rich, Allen S Anderson, Edwin C McGee, Travis O Abicht, Joseph Kang, Valentina Stosor
BACKGROUND: Invasive fungal infections (IFIs) are an infrequent but major complication of heart transplantation (HT). We sought to describe the epidemiology at our institution. METHODS: A prospective cohort study of 159 heart transplant recipients was performed from June 2005 to December 2012. IFIs were defined by European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. RESULTS: By univariate analysis, Hispanic ethnicity was associated with IFI (P=...
December 10, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27927037/clinical-hepatotoxicity-associated-with-antifungal-agents
#11
Ioannis Kyriakidis, Athanasios Tragiannidis, Silke Munchen, Andreas H Groll
Invasive fungal diseases (IFDs) are a leading cause of morbidity and mortality among immunocompromised patients with bone marrow failure syndromes, hematological malignancies, hematopoietic stem cell transplantation (HSCT), those admitted in intensive care units (ICUs) and those with prolonged febrile neutropenia. IFDs occur in a setting of multiple morbidities and are associated with case fatality rates between 30 and 70%. Along with the development of classes and compounds, the last two decades have seen substantial improvements in the prevention and management of these infections and an overall increased use of antifungal agents...
December 16, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27915301/assessing-the-risk-of-false-positive-serum-galactomannan-among-patients-receiving-piperacillin-tazobactam-for-febrile-neutropenia
#12
Hayati Demiraslan, M Altay Atalay, Esma Eren, Koray Demir, Leylagul Kaynar, A Nedret Koc, Mehmet Doganay
Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam...
December 2, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27904061/diagnosis-and-treatment-of-mucormycosis-in-patients-with-hematological-malignancies
#13
Yuki Asano-Mori
The risk of invasive fungal infections (IFIs) is extremely high in patients with hematological malignancies due to the prolonged and profound neutropenia and immunosuppression after chemotherapy and hematopoietic stem cell transplantation. There has been increasing interest in mucormycosis despite its relatively uncommon occurrence, because occasional breakthrough infections have been observed under anti-aspergillus prophylaxis. The aggressive nature of mucormycosis easily leads to high mortality because of delays in diagnosis and incorrect treatment decisions, which are due in part to lack of adjunctive diagnostic tools and having similar clinical and radiological features with aspergillosis...
2016: Medical Mycology Journal
https://www.readbyqxmd.com/read/27875707/mucormycosis-causing-ludwig-angina-a-unique-presentation
#14
Ryan P McSpadden, James R Martin, Swati Mehrotra, Eric Thorpe
Mucormycosis is a rare fungal infection with a yearly incidence of 1.7 cases per million in the United States. It usually occurs in patients with metabolic abnormalities or who are immunocompromised with prolonged neutropenia. However, it can also occur in patients without any underlying disease process. The treatment of choice is surgical debridement of necrotic tissue and systemic antifungal therapy, including amphotericin B. A dilemma for the surgeon when faced with head and neck mucormycosis is the morbidity of surgical debridement from both a functional and cosmetic standpoint...
October 29, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27849440/use-of-cidofovir-for-cytomegalovirus-disease-refractory-to-ganciclovir-in-solid-organ-recipients
#15
Hugo Bonatti, Costi D Sifri, Clara Larcher, Stefan Schneeberger, Camille Kotton, Christian Geltner
BACKGROUND: Solid organ transplantation (SOT) frequently is complicated by cytomegalovirus (CMV) infections. Cidofovir (CDV) is active against CMV, including many ganciclovir (GCV)-resistant mutants, but often is considered to be too nephrotoxic for use after organ transplantation. PATIENTS AND METHODS: Seven males and two females (median age 50.1 years), including two kidney/pancreas, four lung, one small bowel, and two hand recipients, received CDV for refractory CMV disease...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27832748/invasive-mucormycosis-in-children-an-epidemiologic-study-in-european-and-non-european-countries-based-on-two-registries
#16
Zoi Dorothea Pana, Danila Seidel, Anna Skiada, Andreas H Groll, Georgios Petrikkos, Oliver A Cornely, Emmanuel Roilides
BACKGROUND: Mucormycosis has emerged as a rare but frequently fatal invasive fungal disease. Current knowledge on paediatric mucormycosis is based on case reports and small series reported over several decades. Contemporary data on a large cohort of patients is lacking. METHODS: Two large international registries (Zygomyco.net and FungiScope™) were searched for mucormycosis cases in ≤19 year-old patients. Cases enrolled between 2005 and 2014 were extracted, and dual entries in the two databases merged...
November 10, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27811055/m-csf-improves-protection-against-bacterial-and-fungal-infections-after-hematopoietic-stem-progenitor-cell-transplantation
#17
Prashanth K Kandalla, Sandrine Sarrazin, Kaaweh Molawi, Carole Berruyer, David Redelberger, Anne Favel, Christophe Bordi, Sophie de Bentzmann, Michael H Sieweke
Myeloablative treatment preceding hematopoietic stem cell (HSC) and progenitor cell (HS/PC) transplantation results in severe myeloid cytopenia and susceptibility to infections in the lag period before hematopoietic recovery. We have previously shown that macrophage colony-stimulating factor (CSF-1; M-CSF) directly instructed myeloid commitment in HSCs. In this study, we tested whether this effect had therapeutic benefit in improving protection against pathogens after HS/PC transplantation. M-CSF treatment resulted in an increased production of mature myeloid donor cells and an increased survival of recipient mice infected with lethal doses of clinically relevant opportunistic pathogens, namely the bacteria Pseudomonas aeruginosa and the fungus Aspergillus fumigatus M-CSF treatment during engraftment or after infection efficiently protected from these pathogens as early as 3 days after transplantation and was effective as a single dose...
October 17, 2016: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27800196/chronic-disseminated-candidiasis-complicated-by-immune-reconstitution-inflammatory-syndrome-in-child-with-acute-lymphoblastic-leukemia
#18
Olga Zając-Spychała, Bogna Ukielska, Katarzyna Jończyk-Potoczna, Benigna Konatkowska, Jacek Wachowiak
Hepatosplenic candidiasis also known as chronic disseminated candidiasis is a rare manifestation of invasive fungal infection typically observed in patients with acute leukemia in prolonged, deep neutropenia. Immune reconstitution inflammatory syndrome (IRIS) is an inflammatory disorder triggered by rapid resolution of neutropenia. Diagnosis and treatment of IRIS are still challenging due to a variety of clinical symptoms, lack of certain diagnostic criteria, and no standards of treatment. The diagnosis of IRIS is even more difficult in patients with hematological malignancies complicated by "probable" invasive fungal infection, when fungal pathogen is still uncertain...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27729140/invasive-fungal-sinusitis-in-the-pediatric-population-systematic-review-with-quantitative-synthesis-of-the-literature
#19
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
https://www.readbyqxmd.com/read/27704258/radial-ultrasound-assisted-transbronchial-biopsy-a-new-diagnostic-approach-for-non-resolving-pulmonary-infiltrates-in-neutropenic-hemato-oncological-patients
#20
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
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