title: Infections with viridans group streptococci in children with cancer.
abstract: Infection with viridans group streptococci (VGS) causes morbidity and mortality in children with cancer. Incidence of these infections has increased over time. Neutropenic patients with acute myeloid leukemia and those receiving high-dose cytarabine or undergoing stem cell transplantation are at highest risk. One-third of infected patients develop a shock syndrome despite prompt antibiotic therapy. Host defense mechanisms contribute substantially to colonization and tissue damage, but the origin of the shock syndrome is not well understood. VGS infection may be accompanied by neurological complications, myocarditis, and acute respiratory distress syndrome. Routine systemic antimicrobial prophylaxis against VGS infection has not been proven effective. Current recommendations include appropriate antibiotic therapy and intensive supportive care.
authors.affiliation: Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. Reillya@email.CHOP.edu
authors.forename: Anne F
authors.initials: AF
authors.lastname: Reilly
authors.forename: Beverly J
authors.initials: BJ
authors.lastname: Lange
mesh_terms: D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000401:mortality / Q000628:therapy; D009205:Myocarditis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D009422:Nervous System Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D009503:Neutropenia / Q000150:complications; D017410:Practice Guidelines as Topic; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D033581:Stem Cell Transplantation; D013290:Streptococcal Infections / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D034363:Viridans Streptococci
chemical_list: D003561:Cytarabine