Clinical Research Of Invasive Fungal Infection In Children With Acute Leukemia

ObjectiveTo explore the experiences of early diagnosis and treatment of invasive fungal infection by analyzing and summarizing the clinical feature in children with acute leukemia.MethodRetrospective review the six cases of acute leukemia in children with invasive fungal infection which we were treated from 2006 to 2009 in our hospital. The diagnosis was based on the diagnosis and treatment rules of invasive fungal infection in patients with blood disease or malignancy (revision),and combined with host factor,clinical data,microbiological data,high-definition CT and G/GM tests. They were treated by amphotericin B, liposomal amphotericin B, voriconazole, itraconazole and fluconazole, and lasted for 2 months.ResultsIn the six cases, one of them was definitely diagnosed to invasive fungal infection, three of them were clinically diagnosed and two were suspectively diagnosed. All the patients had varying degrees of fever, and had no improvement after combined treatment with various antibiotics, while there had got other symptoms, such as cough,expectoration,abdominal pain and oral ulceration. Three patients had pulmonary infections, and specific "halo"sign was shown on pulmonary CT in two of them. One child had invasive lesions on liver, and one had got a fungemia. Three of them were positive on G assay. After full course of antifungal treatment in sufficient quantities, five of them were clinical cured, and had no relapse in the follow-up chemo-treatment. The other one took a favorable turn and then gave up. ConclusionSevere immune deficiency induced by intense chemotherapy is an important factor of children with malignant hematological disease complicated by invasive fungal infections. In the clinic, we should rationally control the risk factors, give empirical antifungal therapy and effective preemptive therapy in time, combining with relevant laboratory and imaging examination for the opportunity to control the infection. Once diagnosed, we should choose safe and effective drugs, treat with full course in sufficient quantities to prevent recurrence.