title: Invasive mold infections in iatrogenically immunocompromised children: an eight-yr review.
abstract: IMI are emerging as an important cause of mortality and morbidity among the growing number of immunocompromised children. A retrospective chart review was performed in all patients with a proven diagnosis of IMI over an eight-yr period (1997-2004) at The Hospital for Sick Children, Toronto, Canada to document the incidence, clinical spectrum, microbiology, treatment, and outcome of pediatric IMI. Twenty-eight patients developed IMI over the study period (10 cancer, 12 HCT, and six SOT patients). IMI occurred in 0.51%, 2.2% and 3.2% after a median time of 118, 60 and 71 days, among cancer, HCT and SOT recipients, respectively. Aspergillus spp. infection was diagnosed most commonly (23 patients) and the most common site of infection was the lung (21 patients). Patients at increased risk included those with acute myelogenous leukemia, allogeneic unrelated HCT recipients, graft-versus-host disease, and lung transplant recipients. The mortality after one yr was 60% among cancer patients, 58% among HCT patients, and 16% among SOT patients.
authors.affiliation: Division of Infectious Diseases, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Abdulkader
authors.initials: A
authors.lastname: Al-Rezqi
authors.forename: Michael
authors.initials: M
authors.lastname: Hawkes
authors.forename: John
authors.initials: J
authors.lastname: Doyle
authors.forename: Susan E
authors.initials: SE
authors.lastname: Richardson
authors.forename: Upton
authors.initials: U
authors.lastname: Allen
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis*; D001230:Aspergillus / Q000378:metabolism*; D002648:Child; D005658:Fungi; D006086:Graft vs Host Disease / Q000175:diagnosis; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D016040:Lung Transplantation; D009369:Neoplasms / Q000150:complications / Q000382:microbiology; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents