Rare severe mycotic infections in children receiving empirical caspofungin treatment for febrile neutropenia

Brazilian Journal of Infectious Diseases

Karadas, Nihal¹  Karapinar, Deniz Yilmaz¹  Yazici, Pinar¹  Aydinok, Yeşim¹  Karapinar, Bülent¹  Metin, Dilek¹  Duyu, Muhterem¹  Sivis, Zühal Önder¹ 

[1] Ege University Faculty of Medicine, Bornova-Izmir, Turkey

关键词:  Geotrichum capitatum;    Trichosporon asahii;    Invazive fungal infection;    Febrile neutropeniaIntroductionInvasive fungal infections (IFIs) have significant impact on leukemia patients' survival;   

DOI  :  10.1016/j.bjid.2015.06.008

来源: Contexto

【 摘 要 】

Empirical antifungal therapy is most often given to patients with leukemia. However breakthrough fungal infections under antifungal therapy are not uncommon. Four children, with hematologic malignant disease developed mycotic breakthrough infections while on empirical caspofungin treatment for a median of 14 (range 11-19) days. Trichosporon asahii was detected in the blood culture of two patients and Geotrichum capitatum in the other two (one patient also had positive cerebrospinal fluid culture). Because the patients' clinical situation worsened, voriconazole was empirically added for two patients three and five days before the agent was detected. The first sterile blood culture was obtained 3-7 days of voriconazole treatment. All patients reached clear cultures but one patient died. One patient with central nervous system infection with G. capitatum had severe neurological sequelae. Very severe fungal infections can occur during empirical caspofungin therapy. Therefore, patients should be followed closely.

【 授权许可】

Unknown