Clinical Features and Prognosis of Invasive Pulmonary Aspergillosis in Korean Children with Hematologic/Oncologic Diseases

Han, Seung Beom; Kim, Seongkoo; Bae, Eun Young; Lee, Jae Woo; Yoon, Jong-Seo; Chung, Nak Gyun; Cho, Bin; Jeong, Dae Chul; Kang, Jin Han; Kim, Hack Ki; Lee, Dong Gun; Lee, Hyun Sil; Im, Soo Ah

doi:10.3346/jkms.2015.30.8.1121

Cited by 19 publications

(26 citation statements)

References 40 publications

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“…In contrast, nodules were found in 21% of the pediatric patients, corroborating the results of another report (Taccone et al, 1993 ). In contrast, a more recent pediatric study found that the halo sign in the chest CT was significantly associated with pulmonary IA (78.4 vs. 40.7%, P < 0.001) (Han et al, 2015 ). It is unclear whether the different results among the studies simply reflect different time points of CT imaging or are due to other, yet unknown reasons.…”

Section: Imaging Studiesmentioning

confidence: 90%

Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population

et al. 2018

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Invasive aspergillosis (IA) is a major cause of morbidity and mortality in children with hematological malignancies and those undergoing hematopoietic stem cell transplantation. Similar to immunocompromised adults, clinical signs, and symptoms of IA are unspecific in the pediatric patient population. As early diagnosis and prompt treatment of IA is associated with better outcome, imaging and non-invasive antigen-based such as galactomannan or ß-D-glucan and molecular biomarkers in peripheral blood may facilitate institution and choice of antifungal compounds and guide duration of therapy. In patients in whom imaging studies suggest IA or another mold infection, invasive diagnostics such as bronchoalveolar lavage and/or bioptic procedures should be considered. Here we review the current data of diagnostic approaches for IA in the pediatric setting and highlight the major differences of performance and clinical utility of the tests between children and adults.

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Section: Imaging Studiesmentioning

confidence: 90%

Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population

et al. 2018

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“…A strong recommendation to perform lung CTs remained unchanged in the updated CPG. Of the nine studies evaluating lung CT [115][116][117][118][119][120][121][122][123] for the evaluation of IFD, lungs were usually the most frequent site of infection, and characteristic radiographic signs were often observed. A new weak recommendation for abdominal imaging even in the absence of localizing signs or symptoms was made with this CPG update, based on the systematic review (Data Supplement).…”

Section: Recommendationsmentioning

confidence: 99%

Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update

Lehrnbecher

Robinson²,

Fisher

et al. 2017

JCO

384

450

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Purpose To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group of experts in pediatric oncology and infectious diseases that includes a patient advocate. For questions of risk stratification and evaluation, we updated systematic reviews of observational studies. For questions of therapy, we conducted a systematic review of randomized trials of any intervention applied for the empirical management of pediatric FN. The Grading of Recommendation Assessment, Development and Evaluation approach was used to make strong or weak recommendations and to classify levels of evidence as high, moderate, low, or very low. Results Recommendations related to initial presentation, ongoing management, and empirical antifungal therapy of pediatric FN were reviewed; the most substantial changes were related to empirical antifungal therapy. Key differences from our 2012 FN CPG included the listing of a fourth-generation cephalosporin for empirical therapy in high-risk FN, refinement of risk stratification to define patients with high-risk invasive fungal disease (IFD), changes in recommended biomarkers and radiologic investigations for the evaluation of IFD in prolonged FN, and a weak recommendation to withhold empirical antifungal therapy in IFD low-risk patients with prolonged FN. Conclusion Changes to the updated FN CPG recommendations will likely influence the care of pediatric patients with cancer and those undergoing hematopoietic stem-cell transplantation. Future work should focus on closing research gaps and on identifying ways to facilitate implementation and adaptation.

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“…), and candida infections, all of which warrant special attention in neutropenic children. A halo of ground glass opacity may be seen surrounding nodules (“halo sign”); in the setting of neutropenia; this may suggest angioinvasive aspergillosis infection . A crescent‐shaped area of radiolucency in a region of nodular opacity (“air‐crescent sign”) may also be seen, but these findings are infrequent in younger children…”

Section: Cardiothoracic Oncologic Emergenciesmentioning

confidence: 99%

Pediatric oncologic emergencies: Clinical and imaging review for pediatricians

Handa

Nozaki

Makidono

et al. 2019

Pediatrics International

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Children with cancer are at increased risk of life-threatening emergencies, either from the cancer itself or related to the cancer treatment. These conditions need to be assessed and treated as early as possible to minimize morbidity and mortality. Cardiothoracic emergencies encompass a variety of pathologies, including pericardial effusion and cardiac tamponade, massive hemoptysis, superior vena cava syndrome, pulmonary embolism, and pneumonia. Abdominal emergencies include bowel obstruction, intussusception, perforation, tumor rupture, intestinal graftversus-host disease, acute pancreatitis, neutropenic colitis, and obstructive uropathy. Radiology plays a vital role in the diagnosis of these emergencies. We here review the clinical features and imaging in pediatric patients with oncologic emergencies, including a review of recently published studies. Key radiological images are presented to highlight the radiological approach to diagnosis. Pediatricians, pediatric surgeons, and pediatric radiologists need to work together to arrive at the correct diagnosis and to ensure prompt and appropriate treatment strategies.

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Clinical Features and Prognosis of Invasive Pulmonary Aspergillosis in Korean Children with Hematologic/Oncologic Diseases

Cited by 19 publications

References 40 publications

Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population

Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population

Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update

Pediatric oncologic emergencies: Clinical and imaging review for pediatricians

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