Imaging features of fungal infection in immuno-suppressed patients in a local ward outbreak

Sarji, Sazilah Ahmad; Abdullah, WA Wan; Wastie, M. L.

doi:10.2349/biij.2.2.e21

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…Regarding the radiologic evaluation of other sites in children with prolonged febrile neutropenia and a high suspicion of IFD, a recent pediatric guideline included a weak recommendation for routine abdominal imaging, as in four studies, imaging findings in a significant proportion of patients without localizing signs or symptoms were consistent with IFD (Bartley et al, 1982 ; Archibald et al, 2001 ; Ahmad Sarji et al, 2006 ; Cohn et al, 2016 ; Lehrnbecher et al, 2017b ). In contrast, the guideline panel gave a weak recommendation against routine sinus imaging in persistently febrile neutropenic patients in the absence of localizing signs or symptoms, which is based on the observation that sinus imaging is frequently abnormal in these patients and that the findings do not distinguish between children with and without invasive fungal infection of the sinus (Kavanagh et al, 1991 ; Archibald et al, 2001 ; Park et al, 2005 ; Ahmad Sarji et al, 2006 ; Cohn et al, 2016 ; Lehrnbecher et al, 2017b ).…”

Section: Imaging Studiesmentioning

confidence: 99%

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: 99%

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

et al. 2018

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“…may occur more commonly in HIV patients. These rare fungi have all been diagnosed in children [ 11 , 12 ].…”

Section: Other Fungal Pathogensmentioning

confidence: 99%

“…In clinical practice, medical imaging and noninvasive testing such as GM, BDG, and nucleic acid techniques are all part of the diagnostic pathway to track fungal infections, particularly for invasive aspergillosis [ 36 , 37 ]. Plain radiographs, ultrasound (US), conventional CT, HR CT, and MRI all play a role in the diagnosis and management of fungal infections [ 11 , 37 , 38 ], but all have their limitations. MRI is particularly useful for identifying infections in the central nervous system (CNS) and the facial sinuses, which can be rapidly fatal in acute sinusitis [ 12 ].…”

Section: Imagingmentioning

confidence: 99%

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Imaging fungal infections in children

Ankrah

Sathekge

Dierckx

et al. 2016

Clin Transl Imaging

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Fungal infections in children rarely occur, but continue to have a high morbidity and mortality despite the development of newer antifungal agents. It is essential for these infections to be diagnosed at the earliest possible stage so appropriate treatment can be initiated promptly. The addition of high-resolution computer tomography (HR CT) has helped in early diagnosis making; however, it lacks both sensitivity and specificity. Metabolic changes precede anatomical changes and hybrid imaging with positron emission tomography (PET) integrated with imaging modalities with high anatomical resolution such as CT or magnetic resonance imaging (MRI) is likely to detect these infections at an earlier stage with higher diagnostic accuracy rates. Several authors presented papers highlighting the advantages of PET/CT in imaging fungal infections. These papers, however, usually involve a limited number of patients and mostly adults. Fungal infections behave different in children than in adults, since there are differences in epidemiology, imaging findings, and response to treatment with antifungal drugs. This paper reviews the literature and explores the use of hybrid imaging for diagnosis and therapy decision making in children with fungal infections.

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“…These fungi are a major cause of morbidity and mortality, given the increased length of hospital stay [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal candidiasis in children with lymphohematopoietic malignancies in Mashhad, Iran

et al. 2015

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Background and Purpose:Over the past years, the role of fungi as a cause of nosocomial infections in hospitalized patients has been accentuated. Candida species constitute an important group of fungi causing diseases in immunocompromised patients. Oropharyngeal candidiasis continues to be a prevalent infection in immunodeficient patients. In this study, we aimed to determine the incidence of oropharyngeal candidiasis in children with lymphohematopoietic malignancies.Materials and Methods: In total, 102 patients with lymphohematopoietic malignancies and 50 healthy controls were examined in terms of Candida infections via direct sampling of the oropharyngeal cavity. Fresh smears were prepared with 10% potassium hydroxide and Gram staining was carried out. Subsequently, the obtained specimens were cultured on Sabouraud dextrose agar for further analysis. Results:The most common Candida species were Candida albicans (31%), other non-C. albicans species (14.7%), C. glabrata (6.8%), and C. krusei (0.98%) in the case group, while in the control group, other non-C. albicans species (10%) and C. albicans (8%) were the most common species.Conclusion:In the present study, Candida species were the most common fungal pathogens in pediatric cancer patients; therefore, efforts should be made to prevent fungemia and fungal pneumonia. Also, non-C. albicans species must be considered as a new risk factor for pediatric cancer patients.

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Imaging features of fungal infection in immuno-suppressed patients in a local ward outbreak

Cited by 10 publications

References 18 publications

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

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

Imaging fungal infections in children

Oropharyngeal candidiasis in children with lymphohematopoietic malignancies in Mashhad, Iran

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