Hepatosplenic Fungal Infections in Children With Leukemia-Risk Factors and Outcome: A Multicentric Study

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dc.contributor.authorCelkan, Tiraje
dc.contributor.authorKizilocak, Hande
dc.contributor.authorEvim, Melike
dc.contributor.authorGunes, Adalet Meral
dc.contributor.authorOzbek, Namik Y.
dc.contributor.authorYarali, Nese
dc.contributor.authorUnal, Ekrem
dc.contributor.authorPatiroglu, Turkan
dc.contributor.authorKarapinar, Deniz Yilmaz
dc.contributor.authorSarper, Nazan
dc.contributor.authorZengin, Emine
dc.contributor.authorKaraman, Serap
dc.contributor.authorKocak, Ulker
dc.contributor.authorKurekci, Emin
dc.contributor.authorOzdemir, Canan
dc.contributor.authorTugcu, Deniz
dc.contributor.authorUysalol, Ezgi
dc.contributor.authorDikme, Gurcan
dc.contributor.authorAdaletli, Ibrahim
dc.contributor.authorKuruoglu, Sebuh
dc.contributor.authorKebudi, Rejin
dc.date.accessioned2019-10-27T09:44:38Z
dc.date.available2019-10-27T09:44:38Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground: Invasive fungal infections, including hepatosplenic fungal infections (HSFI), cause significant morbidity and mortality in children with leukemia. There are not enough data to support for the best approach to diagnosis of HSFI in children, nor for the best treatment. Procedure: In this multicentric study, we assessed the demographic data, clinical and radiologic features, treatment, and outcome of 40 children with leukemia and HSFI from 12 centers. Results: All cases were radiologically diagnosed with abdominal ultrasound, which was performed at a median of 7 days, of the febrile neutropenic episode. Mucor was identified by histopathology in 1, and Candida was identified in blood cultures in 8 patients. Twenty-two had fungal infection in additional sites, mostly lungs. Nine patients died. Four received a single agent, and 36 a combination of antifungals. Conclusions: Early diagnosis of HSFI is challenging because signs and symptoms are usually nonspecific. In neutropenic children, persistent fever, back pain extending to the shoulder, widespread muscle pain, and increased serum galactomannan levels should alert clinicians. Abdominal imaging, particularly an abdominal ultrasound, which is easy to perform and available even in most resource-limited countries, should be recommended in children with prolonged neutropenic fever, even in the absence of localizing signs and symptoms.en_US
dc.identifier.doi10.1097/MPH.0000000000001431
dc.identifier.endpage260en_US
dc.identifier.issn1077-4114
dc.identifier.issn1536-3678
dc.identifier.issn1077-4114en_US
dc.identifier.issn1536-3678en_US
dc.identifier.issue4en_US
dc.identifier.startpage256en_US
dc.identifier.urihttps://doi.org/10.1097/MPH.0000000000001431
dc.identifier.urihttps://hdl.handle.net/11454/29027
dc.identifier.volume41en_US
dc.identifier.wosWOS:000466030000014en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofJournal of Pediatric Hematology Oncologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjecthepatosplenic fungal infectionsen_US
dc.subjectpediatric leukemiaen_US
dc.subjectinvasive fungal infectionsen_US
dc.titleHepatosplenic Fungal Infections in Children With Leukemia-Risk Factors and Outcome: A Multicentric Studyen_US
dc.typeArticleen_US

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