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儿童癌症患者中毛霉菌病的概述和结果:来自埃及儿童癌症医院的报告。

Overview and outcome of mucormycosis among children with cancer: Report from the Children's Cancer Hospital Egypt.

机构信息

Pediatric Oncology Department, National Cancer Institute-Cairo University, Children Cancer Hospital, Cairo, Egypt.

Clinical Pharmacy, Children Cancer Hospital, Cairo, Egypt.

出版信息

Mycoses. 2019 Nov;62(11):984-989. doi: 10.1111/myc.12915. Epub 2019 Aug 26.

DOI:10.1111/myc.12915
PMID:30983046
Abstract

Mucormycosis represents a real challenge in immunocompromised patients. This study aimed to describe the clinical characteristics, treatment outcome and infection-related mortality in our patients at the Children's Cancer Hospital 57357, Cairo, Egypt. This is a retrospective study during the period 2007-2017. Data analysis included demographic data, risk factors, diagnostic workup, treatment and outcome. During the study period, 45 patients developed proven mucormycosis according to EORTC/MSG criteria (2008). Ninety percentof cases were of haematological malignancies. Liposomal amphotericin B was the mainstay of treatment. Posaconazole was used as secondary prophylaxis in 35% of cases. Combination antifungal was used in three cases with progressive mucormycosis. Surgical intervention was achievable in 50% of cases. Therapy was successful in 35 patients (66%). Complications related to mucormycosis were seen in five cases with disfigurement and perforated hard palate. Chemotherapy delay with subsequent relapse of primary malignancy was reported in one case. Mucormycosis-related mortality was 33% (15 cases). Mucormycosis is a major cause of mortality among patients with haematological malignancies. Early diagnosis of Mucormycosis infection, with rapid initiation of appropriate antifungal therapy and surgical intervention, whenever feasible, is the backbone of mucormycosis treatment.

摘要

毛霉菌病在免疫功能低下的患者中是一个真正的挑战。本研究旨在描述埃及开罗 57357 儿童癌症医院患者的临床特征、治疗结果和与感染相关的死亡率。这是一项回顾性研究,时间为 2007 年至 2017 年。数据分析包括人口统计学数据、危险因素、诊断检查、治疗和结果。在研究期间,根据 EORTC/MSG 标准(2008 年),45 名患者确诊为毛霉菌病。90%的病例为血液系统恶性肿瘤。脂质体两性霉素 B 是主要的治疗方法。35%的病例使用泊沙康唑作为二级预防。在三例进展性毛霉菌病中使用联合抗真菌药物。50%的病例可进行手术干预。35 例患者(66%)的治疗成功。五例患者出现与毛霉菌病相关的并发症,出现畸形和硬腭穿孔。一例患者因化疗延迟和原发性恶性肿瘤复发而出现并发症。与毛霉菌病相关的死亡率为 33%(15 例)。毛霉菌病是血液系统恶性肿瘤患者死亡的主要原因。早期诊断毛霉菌病感染,尽快开始适当的抗真菌治疗和手术干预(如有可能),是毛霉菌病治疗的基础。

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