Rare severe mycotic infections in children receiving empirical caspofungin treatment for febrile neutropenia

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• 作者：Deniz Yilmaz Karapinar^a ; ^{dyilmazk@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Nihal Karada艧^a ; Z&uuml ; hal Ö ; nder Sivi艧^a ; Pinar Yazici^b ; Muhterem Duyu^b ; Dilek Metin^c ; B&uuml ; lent Karapinar^b ; Ye艧im Aydinok^a
• 关键词：Geotrichum capitatum ; Trichosporon asahii ; Invazive fungal infection ; Febrile neutropenia
• 刊名：The Brazilian Journal of Infectious Diseases
• 出版年：2015
• 出版时间：September-October 2015
• 年：2015
• 卷：19
• 期：5
• 页码：549-552
• 全文大小：450 K

文摘

Empirical antifungal therapy is most often given to patients with leukemia. However breakthrough fungal infections under antifungal therapy are not uncommon. Four children, with hematologic malignant disease developed mycotic breakthrough infections while on empirical caspofungin treatment for a median of 14 (range 11–19) days. Trichosporon asahii was detected in the blood culture of two patients and Geotrichum capitatum in the other two (one patient also had positive cerebrospinal fluid culture). Because the patients’ clinical situation worsened, voriconazole was empirically added for two patients three and five days before the agent was detected. The first sterile blood culture was obtained 3–7 days of voriconazole treatment. All patients reached clear cultures but one patient died. One patient with central nervous system infection with G. capitatum had severe neurological sequelae. Very severe fungal infections can occur during empirical caspofungin therapy. Therefore, patients should be followed closely.