Infección micótica profunda en niños con cáncer, neutropenia y fiebre, en Chile

• Yalda Lucero A ^[1] ; Roberto Brücher U ^[1] ; Ana María Alvarez P ^[2] ; Ana Becker K ^[4] ; José Cofré G ^[3] ; Nancy Enríquez O ^[5] ; Ernesto Payá G ^[6] ; Carmen Salgado M ^[5] ; María Elena Santolaya de P ^[3] ; Juan Tordecilla C ^[5] ; Mónica Varas P ^[2] ; Milena Villarroel C ^[3] ; Tamara Viviani ^[4] ; Marcela Zubieta A ^[6] ; Miguel O'Ryan G ^[1]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Hospital San Juan de Dios

     Hospital San Juan de Dios

     Santiago, Chile

     
  3. [3] Hospital Luis Calvo Mackenna

     Hospital Luis Calvo Mackenna

     Santiago, Chile

     
  4. [4] Hospital Sótero del Río
  5. [5] Hospital Roberto del Río
  6. [6] Hospital Exequiel González Cortés

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 130, Nº. 10, 2002, págs. 1139-1146
• Idioma: español
• Títulos paralelos:
  • Invasive fungal infections in children with cancer and febrile neutropenia, in Chile
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• Resumen

  • Background: Invasive fungal infections (IFI) cause prolonged hospitalizations and increase the possibility of death among patients with cancer and febrile neutropenia (FN). Up to 10% of febrile neutropenic episodes may be caused by IFI. Aim: To estimate the incidence of IFI among a large group of Chilean children with cancer and FN. Patients and Methods: Clinical and laboratory information was collected from a data base provided by the "Programa Infantil Nacional de Drogas Antineoplásicas" (PINDA) that included 445 FN episodes occurring in five hospitals in Santiago, Chile. This information was used to identify children that presented with signs and symptoms compatible with an IFI. According to predefined criteria based on a literature review, IFI episodes were categorized as "proven", "probable" or "possible". Results: A total of 41/445 episodes (9.2%) were compatible with an IFI of which 4 (0.9%) were proven, 23 (5.2%) probable, and 14 (3.1%) possible. Hospitalization was longer (27 vs 8 days, p <.01), new infectious foci appeared with higher frequency (71 vs 38%, p <.01), and mortality was higher (10 vs 1.6%, p <.001) in children with IFI compatible episodes, when compared to children who did not have an IFI. Conclusions: The estimated incidence of IFI in Chilean children with cancer and FN ranged between 6-9% depending on the stringency of criteria selection used for classification. This estimate is similar to that reported by other studies. The low detection yield of clinically compatible IFI underscores the need of improved diagnosis of fungal infections in this population (Rev Méd Chile 2002; 130: 1139-46)