[Infection caused by viridans streptococci in children with malignant hematologic diseases]

This is a review of the symptoms and signs of children with malignant diseases and septicemia due to viridans streptococci, treated during a 6-year-period (1990-1995) in the Departments of Pediatrics or Pediatric Surgery, University of Leipzig. All 11 children suffered from leukemia. Streptococcus mitis was the most frequently isolated streptococcal species. All patients had fever and malaise, in most cases we could find inflammatory signs of the respiratory tract. In two children we saw a severe course of the disease, one child had symptoms and signs of ARDS, the other died on septicemic shock. All 11 patients had neutropenia and a central venous line, 10 of them were treated by cytarabine before the streptococcal infection was diagnosed. Like others we could note during the last years an increase of systemic infections due to viridans streptococci in neutropenic patients with malignant diseases. Possibly there is an association between streptococcal infection and cytarabine therapy. The empiric antibiotic therapy in neutropenic patients with malignant diseases should cover also streptococcal infections.