Candidiasis hepatoesplénica en pacientes hemato-oncológicos pediátricos
- Hernández Marqués, C.
- Lassaletta Atienza, Álvaro
- Gonzalez Vicent, Marta
- Sevilla Navarro, J.
- Molina, B.
- Andión Catalán, Maitane
- Cormenzana Carpio, María
- Pérez Martínez, A.
- Díaz Pérez, M.A.
- Madero López, Luis
ISSN: 1695-4033, 1696-4608
Année de publication: 2011
Volumen: 75
Número: 1
Pages: 26-32
Type: Article
D'autres publications dans: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Résumé
Introduction In the last few decades, the survival of children with haematology-oncological malignancies has increased due to more aggressive chemotherapy regimens. This has led to an increase of fungal infections causing significant morbidity and mortality in these patients. Hepatosplenic candidiasis is a disseminated candida infection that affects most commonly the liver and spleen, although other organs may be involved. Patients and methods We performed a retrospective study of 13 paediatric patients diagnosed with hepatosplenic candidiasis from January 2002 to February 2010 in our paediatric haematology-oncology department following the criteria proposed by the EORTC/MSG (European Organization for Research and Treatment of Cancer and Mycoses study group) updated in 2008. We analysed the clinical characteristics, diagnostic methods, treatment and outcome. Results The most common symptom of presentation of hepatosplenic candidiasis in our series was persistent fever, up 84.6% of cases, almost all associated with other symptoms. Risk factors for development are non-specific and were present in 92.3% of our patients. The diagnosis of proven infection, which is made by histology or culture, is usually difficult to obtain and in our series it was obtained only in 23.1% of cases. As in our series, diagnosis is often presumptive. Laboratory tests are not useful in the paediatric population and only in one patient we observed an increase in alkaline phosphatase at diagnosis. This result differs from the behaviour of this biological marker in adults. Although prolonged treatment is often necessary for the resolution of the lesions, survival is high with appropriate treatment, 100% in our series. Conclusions The mortality of hepatosplenic candidiasis is low with early and adequate treatment.