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

Brazilian Journal of Infectious Diseases

Deniz Yilmaz Karapinar¹  Nihal Karadas¹  Zühal Önder Sivis¹  Pinar Yazici¹  Muhterem Duyu¹  Dilek Metin¹  Bülent Karapinar¹  Yeşim Aydinok¹ 

关键词: Geotrichum capitatum;    Trichosporon asahii;    Invazive fungal infection;    Febrile neutropenia;   

DOI  :  10.1016/j.bjid.2015.06.008

来源: SciELO

【 摘 要 】

ABSTRACTEmpirical 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】

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