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Candida tropicalis fungemia in children with leukemia and lymphoma

J L Huang1, C P Yang, I J Hung

  • 1Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.

Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|July 1, 1993
PubMed

Insights

Fungal bloodstream infections (fungemias) are rare but serious in children with leukemia or lymphoma, often occurring with severe neutropenia. Early antifungal treatment is crucial for improving the poor survival rates in these vulnerable patients.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Hematology

Background:

  • Fungal bloodstream infections (fungemias) represent a significant complication in immunocompromised pediatric patients.
  • Leukemia and lymphoma patients are particularly susceptible due to intensive treatments and prolonged neutropenia.

Observation:

  • Five cases of fungemia occurred in children with leukemia or lymphoma between 1978 and 1990, accounting for 3.4% of all septicemias.
  • Patients presented with fever, severe neutropenia lasting over a week, and often preceded by bacteremia.
  • Common symptoms included fever, chills, and gastrointestinal issues, with varied other systemic manifestations.

Findings:

  • Fungemia episodes occurred during induction or relapse phases of cancer treatment.
  • Only one of the five patients survived, highlighting the critical prognosis.
  • Species causing fungemia were often isolated from other body sites, aiding diagnosis.

Implications:

  • The study underscores the poor prognosis of fungemia in pediatric leukemia/lymphoma patients.
  • Empiric antifungal therapy is recommended for neutropenic patients with persistent fever despite broad-spectrum antibiotics.
  • Prompt diagnosis and intervention are vital to improve outcomes in this high-risk population.

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