Varicella-Zoster Virus Infections in Pediatric Malignancy Patients: A Seven-Year Analysis
Mine Düzgöl1, Gülcihan Özek, Nuri Bayram
1Dr. Behçet Uz Children Training and Research Hospital, Clinic of Pediatric Infectious Diseases, İzmir, Turkey, Phone: +90 232 489 56 56,
Insights
Varicella-zoster virus (VZV) infections in pediatric cancer patients can lead to significant mortality and chemotherapy delays. Early diagnosis and treatment are crucial for managing this contagious disease in immunocompromised children.
Area of Science:
- Infectious Diseases
- Pediatric Oncology
Background:
- Varicella-zoster virus (VZV) infection is typically benign but poses risks to immunocompromised individuals.
- Pediatric cancer patients are particularly vulnerable to severe VZV complications.
Purpose of the Study:
- To review the outcomes and treatment of VZV infections in pediatric malignancy patients.
- To assess the impact of VZV infection on chemotherapy schedules and patient mortality.
Main Methods:
- Retrospective review of 41 pediatric malignancy patients diagnosed with VZV infection.
- Analysis of treatment regimens, including intravenous acyclovir duration.
- Evaluation of chemotherapy delays and VZV-related complications.
Main Results:
- All 41 patients received intravenous acyclovir for a median of 7 days.
- A mean chemotherapy delay of 8 days was observed.
- 7% of patients experienced VZV-related complications, including acute respiratory distress syndrome and hemophagocytic lymphohistiocytosis, with one fatality.
Conclusions:
- VZV infections remain a significant concern in pediatric cancer patients, contributing to mortality.
- VZV infection necessitates treatment delays, impacting cancer therapy efficacy.
- Prompt management of VZV is essential to mitigate severe outcomes in this vulnerable population.
Abstract:
Primary varicella-zoster virus (VZV) infection is a benign self-limited disease. In this study, we review our experience in focusing on the outcome and treatment of VZV infection in pediatric malignancy patients. During the study period, a total of 41 patients with pediatric malignancy had been hospitalized with the diagnosis of VZV infection. All the patients were treated with intravenous acyclovir for a median of 7 days (ranging from 5 to 21 days). The calculated attributable delay of chemotherapy due to VZV infections was 8 days (ranging from 2 to 60 days). VZV-related complications were observed in 3 of 41 patients (7%) who suffered from acute respiratory distress syndrome, and one of them with hemophagocytic lymphohistiocytosis died due to respiratory failure despite acyclovir and broad-spectrum antimicrobial treatment plus supportive treatment. VZV infections are still important contagious diseases in pediatric cancer patients, because they cause not only significant mortality but also a delay in chemotherapy.
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