Invasive fungal infections in children with leukaemia in a tertiary
hospital in Oman, 8-year review.
Abstract
Background: Invasive fungal disease (IFD) is a common and
serious consequence of leukaemia in children and the incidence of these
infections increased due to chemotherapy. We present the epidemiology of
IFD in a cohort of children with leukaemia from a tertiary reference
institution in Oman. Methods: A retrospective study of IFDs in
pediatric patients with newly diagnosed or relapsed leukemia was
conducted at the Royal Hospital in Muscat, Oman. From 2010 to 2017, IFD
episodes in children with leukemia were evaluated retrospectively,
taking into account age, gender, type of leukaemia, chemotherapy
regimen, IFD detection phase, neutropenia, prophylaxis, diagnostic
method, and treatment. Results: Between 2010 and 2017, 198
children with leukemia were admitted and treated at Royal Hospital. In
retrospect, the IFI were defined as probable and proven in 53 % (17
patients) and 47% (15 patients) of the attacks. At 1.1:1, the
male-to-female ratio was roughly equal. According to chest computed
tomography (CT) scans, 65.6% of patients had radiological features of
fungal infections. Positive fungal cultures were found in three
patients’ bronchoalveolar lavage (BAL), 37.5% of whom had positive
blood cultures, and 3% of whom had positive urine cultures. In 3
patients, invasive aspergillosis caused pulmonary IFD, accounting for
9.3% of all infection sites. Candidaemia was found in 28% of IFD
patients. The most common organism was Candida tropicalis
(15.6%), followed by Candida prapsilosis (6.25%).
Conclusion: In children with leukemia, invasive fungal
infection is common and serious. Despite aggressive treatment, mortality
among these high-risk patients remains high.