المؤلفون: Benish, Marganit, Elitzur, Sarah, Arad-Cohen, Nira, Barg, Assaf Arie, Ben-Harosh, Miriam, Bielorai, Bella, Fischer, Salvador, Gilad, Gil, Levy, Itzhak, Rosenfeld-Keidar, Hila, Shachor-Meyouhas, Yael, Soen-Grisaru, Galia, Weinreb, Sigal, Nirel, Ronit, Elhasid, Ronit

المصدر: Journal of Fungi; Apr2022, Vol. 8 Issue 4, p387-387, 13p

مصطلحات موضوعية: STEM cell transplantation, FUSARIOSIS, PEDIATRIC hematology, HEMATOLOGIC malignancies, CHILD patients, OVERALL survival

مستخلص: Invasive Fusarium species infections in immunocompromised patients occur predominantly in those with hematological malignancies. Survival rates of 20–40% were reported in adults, but data in children are limited. Our retrospective, nationwide multicenter study of invasive fusariosis in pediatric hematology/oncology and stem cell transplant (SCT) patients identified twenty-two cases. Underlying conditions included hematological malignancies (n = 16; 73%), solid tumors (n = 2), and non-malignant hematological conditions (n = 4). Nineteen patients (86%) were neutropenic, nine (41%) were SCT recipients, and seven (32%) received corticosteroids. Sixteen patients (73%) had disseminated fusariosis, five had local infection, and one had isolated fungemia. Fifteen patients (68%) had skin involvement and eight (36%) had a bloodstream infection. Four patients (18%) presented with osteoarticular involvement and four with pulmonary involvement. Nineteen patients (86%) received combination antifungal therapy upfront and three (14%) received single-agent treatment. Ninety-day probability of survival was 77%: four of the five deaths were attributed to fusariosis, all in patients with relapsed/refractory acute leukemias. Ninety-day probability of survival for patients with relapsed/refractory underlying malignancy was 33% vs. 94% in others (p < 0.001). Survival rates in this largest pediatric population-based study were strikingly higher than those reported in adults, demonstrating that invasive fusariosis is a life-threatening but salvageable condition in immunosuppressed children. [ABSTRACT FROM AUTHOR]

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المؤلفون: Elitzur, Sarah, Fischer, Salvador, Arad-Cohen, Nira, Barg, Assaf, Ben-Harosh, Miriam, Danino, Dana, Elhasid, Ronit, Gefen, Aharon, Gilad, Gil, Levy, Itzhak, Shachor-Meyouhas, Yael, Weinreb, Sigal, Izraeli, Shai, Barzilai-Birenboim, Shlomit

المصدر: Journal of Fungi; Mar2021, Vol. 7 Issue 3, p1-13, 13p

مصطلحات موضوعية: IMMUNOCOMPROMISED patients, ANTIFUNGAL agents, MUCORMYCOSIS, HEMATOPOIETIC stem cell transplantation, ECHINOCANDINS, PEDIATRIC hematology

مستخلص: Background: Mucormycosis is a life-threatening infection with a tendency for angioinvasion that may lead to progressive dissemination. Disseminated mucormycosis, defined as the involvement of two or more non-contiguous sites, is rare in children, and data concerning its management and outcome are scarce. The aim of this study was to assess the contemporary management strategies and outcomes of disseminated mucormycosis in the pediatric population. Methods: We conducted a retrospective search in six large tertiary medical centers for all cases of disseminated mucormycosis that occurred between 2009–2020 in patients aged 1–20 years. Results: Twelve cases were identified. Underlying conditions included hematological malignancies (n = 10), solid tumor (post-autologous hematopoietic stem cell transplantations; n = 1), and solid organ (liver) transplantation (n = 1). In all cases, amphotericin B formulations were administered as first-line therapy; in eight cases, they were also administered in combination with an echinocandin or triazole. Seven patients underwent surgical debridement procedures. The six-week mortality was 58%. Among the patients diagnosed between 2009–2015, one of the six survived, and of those diagnosed between 2016–2020, four of the six were salvaged. Conclusions: Disseminated mucormycosis is a life-threatening and often fatal disease, and improved diagnostic and therapeutic strategies are needed. Nevertheless, in this population-based study, five patients (42%) were salvaged through combined liposomal amphotericin/triazole treatment and extensive surgical interventions. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Fungi is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)