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fungal infection and neutropenia

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https://www.readbyqxmd.com/read/29771293/breakthrough-fungal-infections-in-leukemia-patients-receiving-isavuconazole
#1
Caitlin R Rausch, Adam J DiPippo, Prithviraj Bose, Dimitrios P Kontoyiannis
Isavuconazole (ISA) is increasingly used in leukemia patients. We retrospectively assessed breakthrough invasive fungal infections (b-IFIs) in 100 consecutive leukemia patients receiving ISA as single agent; 13 developed documented b-IFIs. (6 candidiasis, 6 mold infections, 4 mucormycosis). All b-IFIs were observed in patients with prolonged neutropenia and active leukemia.
May 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29675561/de-escalation-of-antifungal-treatment-in-critically-ill-patients-with-suspected-invasive-candida-infection-incidence-associated-factors-and-safety
#2
Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu, Saad Nseir
BACKGROUND: Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in critically ill patients...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29670779/pulmonary-mucormycosis-in-chronic-lymphocytic-leukemia-and-neutropenia
#3
Izza Mir, Sijan Basnet, David Ellsworth, Elan Mohanty
Pulmonary mucormycosis is a rare life-threatening fungal infection associated with high mortality. We present the case of a 61-year-old man with history of chronic lymphocytic leukemia who presented with fever and cough, eventually diagnosed with pulmonary mucormycosis after right lung video-assisted thoracoscopic surgery. The patient was successfully treated with amphotericin B and right lung pneumonectomy; however, he later died from left lung pneumonia.
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29670632/quantitative-simulations-predict-treatment-strategies-against-fungal-infections-in-virtual-neutropenic-patients
#4
Sandra Timme, Teresa Lehnert, Maria T E Prauße, Kerstin Hünniger, Ines Leonhardt, Oliver Kurzai, Marc Thilo Figge
The condition of neutropenia, i.e., a reduced absolute neutrophil count in blood, constitutes a major risk factor for severe infections in the affected patients. Candida albicans and Candida glabrata are opportunistic pathogens and the most prevalent fungal species in the human microbiota. In immunocompromised patients, they can become pathogenic and cause infections with high mortality rates. In this study, we use a previously established approach that combines experiments and computational models to investigate the innate immune response during blood stream infections with the two fungal pathogens C...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29627936/invasive-fungal-infections-associated-with-prior-respiratory-viral-infections-in-immunocompromised-hosts
#5
Saira Ajmal, Maryam Mahmood, Omar Abu Saleh, Jenifer Larson, M Rizwan Sohail
BACKGROUND: Increased risk of invasive pulmonary aspergillosis after influenza infection has been reported; however data are limited. PURPOSE: To describe Invasive fungal infections (IFI) associated with preceding respiratory viral infection at a large referral center. METHODS: We reviewed all IFI cases among patients with positive influenza and/or RSV nasopharyngeal/lower respiratory tract PCR from October 2015 to December 2016. Cases of pulmonary IFI were classified as possible, probable, and definite based on EORTC-MSG definitions...
April 7, 2018: Infection
https://www.readbyqxmd.com/read/29577051/-aspergillus-fumigatus-infection-induced-neutrophil-recruitment-and-location-in-the-conducting-airway-of-immunocompetent-neutropenic-and-immunosuppressed-mice
#6
Marina A Shevchenko, Andrey O Bogorodskiy, Natalia I Troyanova, Ekaterina A Servuli, Elena L Bolkhovitina, Georg Büldt, Christoph Fahlke, Valentin I Gordeliy, Thomas Gensch, Valentin I Borshchevskiy, Alexander M Sapozhnikov
Susceptibility to fungal infection is commonly associated with impaired neutrophil responses. To study the mechanisms underlying this association, we investigated neutrophil recruitment to the conducting airway wall after Aspergillus fumigatus conidium inhalation in mouse models of drug-induced immunosuppression and antibody-mediated neutrophil depletion (neutropenia) by performing three-dimensional confocal laser-scanning microscopy of whole-mount primary bronchus specimens. Actin staining enabled visualization of the epithelial and smooth muscle layers that mark the airway wall...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29564800/impact-of-the-d-index-deduced-from-duration-and-intensity-of-neutropenia-following-chemotherapy-on-the-risk-of-invasive-fungal-infection-in-pediatric-acute-myeloid-leukemia
#7
Hirozumi Sano, Ryoji Kobayashi, Daisuke Suzuki, Daiki Hori, Kenji Kishimoto, Kunihiko Kobayashi
Pediatric patients with acute myeloid leukemia (AML) are at high risk of invasive fungal infection (IFI). In adult patients, the D-index, which reflects the duration and intensity of neutropenia, was reported as a predictive factor of IFI after induction therapy for AML. The aim of this study was to assess whether the D-index is a predictive factor for IFI in pediatric AML. We define the D-index as the area over the neutrophil curve during neutropenia. Ninety-two courses of chemotherapy performed for 24 consecutive patients with AML undergoing chemotherapy at Sapporo Hokuyu Hospital between April 2007 and March 2017 were analyzed...
March 21, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29564632/infections-caused-by-fusarium-species-in-pediatric-cancer-patients-and-review-of-published-literature
#8
Mariana Volpe Arnoni, Claudete Rodrigues Paula, Marcos Ereno Auler, Cirilo Cesar Naozuka Simões, Shirley Nakano, Maria Walderez Szeszs, Márcia de Souza Carvalho Melhem, Virgínia Bodelão Richini Pereira, Hans Garcia Garces, Eduardo Bagagli, Eriques Gonçalves Silva, Melissa Ferreira de Macêdo, Luciana da Silva Ruiz
Fusarium species have emerged as responsible for a broad spectrum of infections, including superficial, locally invasive and disseminated ones, especially in the hospital environment. Since there are few reports of invasive and disseminated fusariosis in children, the aim of this study was to report four cases of nosocomial infection caused by this microorganism in children with cancer hospitalized in a public children's hospital located in Brazil. Two of these patients were female and two were male. All patients presented febrile neutropenia, while three patients had acute lymphocytic leukemia and one patient had Wilms' tumor as underlying disease...
March 21, 2018: Mycopathologia
https://www.readbyqxmd.com/read/29560305/invasive-pulmonary-mucormycosis-and-aspergillosis-in-a-patient-with-decompensated-hepatic-cirrhosis
#9
Jon G Persichino, Argun D Can, Tam T Van, Michele N Matthews, Scott G Filler
Invasive pulmonary mucormycosis and aspergillosis are rare, life-threatening fungal infections. Most documented cases have been reported in non-cirrhotic patients with diabetes mellitus, neutropenia, or treatment with corticosteroids. The prevalence of each infection is low among patients with hepatic cirrhosis. We report the first likely case of combined invasive pulmonary mucormycosis and aspergillosis in a male with decompensated hepatic cirrhosis. This report also highlights the first non-diabetic case of invasive pulmonary mucormycosis with decompensated hepatic cirrhosis...
September 2018: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/29554829/prolonged-voriconazole-treatment-in-a-patient-with-chronic-lymphocytic-leukemia-resulting-in-a-litany-of-chronic-overlapping-toxicities
#10
Caitlin R Rausch, Dimitrios P Kontoyiannis
Voriconazole is a triazole antifungal with activity against a number of yeast and mold species including Candida, Aspergillosis, Fusarium, and Coccidioides. Invasive fungal infections are associated with high morbidity and mortality, prolonged treatment courses, and occasionally lifelong suppressive therapy. Voriconazole therapy can result in a number of acute toxicities that clinicians are frequently aware of including hepatotoxicity, visual disturbances, and hallucinations; however, there is limited experience with extended durations of voriconazole therapy...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29552004/timing-determination-of-invasive-fungal-infection-prophylaxis-according-to-immune-function-in-hsct-patients
#11
Jiexian Ma, Yingwei Hu, Min Wu, Xiaoqin Wang, Yanhui Xie
Patients who receive a hematopoietic stem cell transplantation (HSCT) exhibit an immune defect after recovering from neutropenia. The current guidelines do not recommend fungal prophylaxis in these patients, except for grades III to IV GVHD in HSCT. Thus, the timing for the initiation and cessation of IFI prophylaxis in immune-compromised patients remains a challenging endeavor. We retrospectively analyzed patients who received auto or allo-HSCT and monitored their immune function after recovering from neutropenia by measuring the levels of IgG, IgA, IgM, as well as the number of T, B, NK cells...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29532539/co-transplantation-of-haploidentical-hematopoietic-stem-cell-and-allogeneic-bone-marrow-derived-mesenchymal-stromal-cells-as-a-first-line-treatment-in-very-severe-aplastic-anemia-patients-with-refractory-infections
#12
Chunyan Yue, Yingying Ding, Yang Gao, Li Li, Yan Pang, Zenghui Liu, Hang Zhang, Yang Xiao, Zujun Jiang, Haowen Xiao
OBJECTIVES: In patients with very severe aplastic anemia (VSAA), neutropenia is prolonged and persistent, resulting in refractory overwhelming infections. Hematopoiesis recovery is urgently needed. METHODS: Six patients with de novo VSAA lacking HLA-identical sibling donors and those who experienced refractory infections, underwent haploidentical related donor (HRD) hematopoietic stem cell transplantation (HSCT) as a first-line therapy. The conditioning regimen consisted of busulfan, cyclophosphamide and rabbit antithymocyte globulin...
March 12, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29509845/serious-infections-in-patients-receiving-ibrutinib-for-treatment-of-lymphoid-malignancies
#13
Tilly Varughese, Ying Taur, Nina Cohen, M Lia Palomba, Susan K Seo, Tobias M Hohl, Gil Redelman-Sidi
Background: Ibrutinib is a Bruton's tyrosine kinase inhibitor that is used for the treatment of lymphoid malignancies, including chronic lymphocytic leukemia (CLL), Waldenström's macroglobulinemia and mantle cell lymphoma (MCL). Several case series have described opportunistic infections among ibrutinib recipients, but the full extent of these infections is unknown. We sought to determine the spectrum of serious infections associated with ibrutinib treatment. Methods: We reviewed the electronic medical records of patients with lymphoid malignancies at Memorial Sloan Kettering Cancer Center who received ibrutinib during a five-year period from January 1, 2012 to December 31, 2016...
March 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29478800/granulocyte-transfusions-in-the-management-of-neutropenic-fever-a-pediatric-perspective
#14
REVIEW
Dilek Gurlek Gokcebay, Sibel Akpinar Tekgunduz
Severe neutropenia-associated invasive bacterial or fungal infections are still the major cause of mortality and morbidity in children receiving cancer chemotherapy. Granulocyte transfusion therapy has been used for many years in the management of neutropenic patients with severe infections in whom the clinical condition deteriorated despite appropriate antimicrobial treatment. Transfused granulocytes can increase the recipient's blood neutrophil count and accumulation of them into the site of infection. There are some data obtained from retrospective or prospective observational studies in pediatric granulocyte transfusion therapy, but results are not conclusive...
February 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29437588/early-onset-invasive-aspergillosis-and-other-fungal-infections-in-patients-treated-with-ibrutinib
#15
David Ghez, Anne Calleja, Caroline Protin, Marine Baron, Marie-Pierre Ledoux, Gandhi Damaj, Mathieu Dupont, Brigitte Dreyfus, Emmanuelle Ferrant, Charles Herbaux, Kamel Laribi, Ronan Le Calloch, Marion Malphettes, Franciane Paul, Laetitia Souchet, Malgorzata Truchan-Graczyk, Karen Delavigne, Caroline Dartigeas, Loïc Ysebaert
Ibrutinib has revolutionized the management of chronic lymphocytic leukemia and is now being increasingly used. Although considered to be less immunosuppressive than conventional immunochemotherapy, the observation of a few cases of invasive fungal infections in patients treated with ibrutinib prompted us to conduct a retrospective survey. We identified 33 cases of invasive fungal infections in patients receiving ibrutinib alone or in combination. Invasive aspergillosis (IA) was overrepresented (27/33) and was associated with cerebral localizations in 40% of the cases...
April 26, 2018: Blood
https://www.readbyqxmd.com/read/29416363/liver-fungal-infections-an-overview-of-the-etiology-and-epidemiology-in-patients-affected-or-not-affected-by-oncohematologic-malignancies
#16
REVIEW
Marco Fiore, Marco Cascella, Sabrina Bimonte, Alberto Enrico Maraolo, Ivan Gentile, Vincenzo Schiavone, Maria Caterina Pace
Fungal infections of the liver, most commonly caused by Candida spp., often occur in patients with hematologic malignancies treated with chemotherapy. Colonization of the gastrointestinal tract is thought to be the main origin of dissemination of Candida ; mucositis and neutropenia facilitate the spread of Candida from the gastrointestinal tract to the liver. Hepatic involvement due to other fungi is a less common infectious complication in this setting. Fungal infections represent a less common cause of hepatic abscesses in non-oncohematologic population and the trend appears to be decreasing in recent years...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29411126/febrile-events-in-acute-lymphoblastic-leukemia-a-prospective-observational-multicentric-seifem-study-seifem-2012-b-all
#17
MULTICENTER STUDY
Roberta Di Blasi, Chiara Cattaneo, Russell E Lewis, Mario Tumbarello, Laura Angelici, Giulia Dragonetti, Alessandro Busca, Benedetta Cambò, Anna Candoni, Monica Cesarini, Simone Cesaro, Mario Delia, Rosa Fanci, Francesca Farina, Mariagrazia Garzia, Antonio Giordano, Bruno Martino, Lorella Melillo, Gianpaolo Nadali, Vincenzo Perriello, Marco Picardi, Angela Maria Quinto, Prassede Salutari, Angelica Spolzino, Adriana Vacca, Calogero Vetro, Michelle Zancanella, Annamaria Nosari, Franco Aversa, Livio Pagano
The purpose of the present study is to estimate the current incidence of febrile events (FEs) and infectious episodes in acute lymphoblastic leukemia (ALL) and evaluate the outcome. We analyzed data on all FEs in a cohort of patients affected by ALL admitted to 20 Italian hematologic centers during 21 months of observation from April 1, 2012 to December 31, 2013. Data about treatment phase, steroids, neutropenia, type and site of infection, and outcome of infection were collected. The population comprehended 271 ALL adult patients...
May 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29391334/invasive-fungal-infections-in-patients-with-hematological-malignancies-emergence-of-resistant-pathogens-and-new-antifungal-therapies
#18
Maria N Gamaletsou, Thomas J Walsh, Nikolaos V Sipsas
Invasive fungal infections caused by drug-resistant organisms are an emerging threat to heavily immunosuppressed patients with hematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis and empirical and preemptive therapy, result in long-term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the nonlinear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors...
March 1, 2018: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/29365030/practical-diagnostic-approach-to-the-presence-of-hyphae-in-neuropathology-specimens-with-three-illustrative-cases
#19
Jesus A Chavez, Daniel J Brat, Steven B Hunter, Jose Velazquez Vega, Jeannette Guarner
Objectives: Early and accurate diagnosis remains crucial in the therapeutic management of invasive central nervous system fungal infections. Different molds have intrinsic resistance to antifungal agents; thus, morphologic differentiation is helpful to clinicians. Methods: Using three examples, we present a guide on how to approach neuropathology specimens where hyphae are identified on initial histologic examination. Results: Hyphae can be classified into three basic groups: hyaline pauciseptated, hyaline septated, and pigmented or dematiaceous...
January 29, 2018: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29330406/adjuvant-role-of-septifast-to-improve-the-diagnosis-of-sepsis-in-a-large-cohort-of-hematological-patients
#20
Raffaella Greco, Maria Chiara Barbanti, Nicasio Mancini, Lara Crucitti, Chiara Oltolini, Alessandra Forcina, Francesca Lorentino, Luca Vago, Carlo Messina, Daniela Clerici, Mara Morelli, Fabio Giglio, Maria Teresa Lupo Stanghellini, Laura Infurnari, Matteo G Carrabba, Sarah Marktel, Andrea Assanelli, Paolo Scarpellini, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Massimo Clementi, Fabio Ciceri
Febrile neutropenia and sepsis are common and life-threatening complications in hematological diseases. This study was performed retrospectively in 514 patients treated for febrile neutropenia at our institute, to investigate the clinical usefulness of a molecular tool, LightCycler® SeptiFast test (SF), to promptly recognize pathogens causing sepsis in hematological patients. We collected 1837 blood samples of 514 consecutive hematological patients. The time of processing is short. Overall, 757 microorganisms in 663 episodes were detected by molecular test and standard blood cultures (BC): 73...
April 2018: Bone Marrow Transplantation
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