2018, Number 4
Invasive fungal disease by filamentous fungi: clinical-epidemiological profile and pharmacological response in a third level hospital in Mexico
Full text
Language: Spanish
References: 9
Page: 152-158
PDF size: 310.83 Kb.
ABSTRACT
Introduction: The invasive fungi disease (IFD) are cause of morbidity and mortality in immunodeficient patients. Among the filament fungi, the most frequent is Aspergillus spp, follow by Hyalohyphomycosis y Zygomycetes that causes mucormycosis. Its microbiological determination could be difficult; therefore, it is important de diagnosis suspicion according to risk factors and if so, start specific treatment and increase the disease prognosis. Objectives: To describe the epidemiological and clinic features, and the pharmacological response among pediatric patients with IFD by filament fungi between January 1st, 2011 to December 31st, 2017 from Instituto Nacional de Pediatría. Material y methods: It was made a patient list, who had an IFD, took from hospital discharge data, and data from Pathology and Mycology Services. It was taken information from the clinical records corresponding to the statistical variables that included patient with IFI according to ECORTC/MSG diagnosis criteria. The information was included in an Excel program database and analyzed by SPSS 21.0 descript statistic. Results: 31 patients were identified: 18 (58%) had Aspergillosis, 9 (30%) Fusariosis, and 4 (12) Mucormycosis. The age range was from 16 days-old to 16 years old. The most important comorbidities for immunosuppression were oncohematological causes: acute lymphoblastic leukemia, and Primary Immunodeficiencies: chronic granulomatosis disease. In Aspergillosis the most frequent clinical presentation was pulmonary 61% (11), follow by brain 17% (3), skin 11% (2), rhinosinual and otomastoid 6% (1) each one. Of the cases fusariosis that in total were 9 cases 3 (33%) ecthyma gangrenosum, 2 (22%) with bacteremia and other presentations that included only one patient was neurological impairment. For Mucormycosis, four patients were reported. 75% rhinoorbital and one case representing 25% as necrotizing enterocolitis. The 80% received monotherapy, 60% with voriconazole and 20% with amphotericin duration of the average treatment was 116 days (14-540 days). Conclusions: The study replicated similar results in other clinical studies. According to the clinical characteristics referred to keep high suspected of these infections due to the fatal outcome with which they usually attend.REFERENCES
De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T et al. Revised Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clinical Infectious Diseases: An Official Publication of the IDSA. 2008; 46 (12): 1813-1821. http://doi.org/10.1086/588660.
Abidi MZ, Sohail MR, Cummins N, Wilhelm M et al. Stability in the cumulative incidence, severity and mortality of 101 cases of invasive mucormycosis in high-risk patients from 1995 to 2011: a comparison of eras immediately before and after the availability of voriconazole and echinocandin amphotericin combination therapies. Mycoses. 2014; 57 (11): 687-698. Epub 2014.