[Fungal infections in pediatric oncology].
The clinical charts of cancer patients with documented fungal infections hospitalized at G. Gaslini Children's Hospital, Italy, from 1980 to 1990 were reviewed. Thirty-seven episodes developing in 37 patients were identified, based on microbiological and/or histological documentation. Patients' age ranged from 3 months to 18 years (median 7 years). Twenty patients were treated for hematological malignancy and 17 had solid tumor. Seven patients (3 with leukemia and 4 with solid tumours), developed mycosis after bone marrow transplantation procedure. A history of neutropenia in the month preceding the documentation of fungal infection was present in 76% of cases (28 of 37). However, only 16 of 28 (55%) of these patients were still neutropenic at time of diagnosis. In 40% of the cases the fungal infection developed as primary infection not preceded by any febrile and/or infectious episode. Fungemias without evident organ localization accounted for the 40% of episodes with a mortality rate of 20%. The other 22 cases (60%) were classified as invasive mycoses; 9 of these patients died (41%). Mortality was higher among patients with mold infection (5 of 7, 72%), than in those with yeast infection (7 of 29.24%). Molds infections and invasive mycoses were virtually absent in the first part of our period of observation (1980-84), but emerged in the second period (1985-90) when also the incidence rate of fungal disease increased (from 2.67/10,000 person/day to 5.93), probably in relation with extensive construction works and with the implementation of a bone marrow transplantation program.
Manfredini
L
L
IV Divisione di Pediatria, Istituto Scientifico Giannina Gaslini di Genova, Italia.
Garaventa
A
A
Castagnola
E
E
Viscoli
C
C
Moroni
C
C
Dini
G
G
Garrè
M L
ML
Manno
G
G
Savioli
C
C
Kotitsa
Z
Z
D000293:Adolescent; D000367:Age Factors; D001228:Aspergillosis / Q000453:epidemiology / Q000401:mortality; D002177:Candidiasis / Q000453:epidemiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D005670:Fusarium; D006801:Humans; D007223:Infant; D008297:Male; D009181:Mycoses / Q000453:epidemiology* / Q000401:mortality; D009369:Neoplasms / Q000150:complications*; D010843:Pichia; D012189:Retrospective Studies; D014250:Trichosporon
Infezioni fungine in oncologia pediatrica.