Clinical Analysis Of Invasive Fungal Disease In Children And Value Of Serum G Test And GM Test

Objective: To evaluate the clinical value of serum(1,3)-β-D-glucan and serum galactomannan assay in diagnosis of invasive fungal disease(IFD)in children with high risk factors and analyze clinical characteristics of IFD.Methods: Retrospective analysis was performed on children admitted in Children’s Hospital of Chongqing Medical University between January2014 and December 2018,who were at risk of IFD.BDG,GM assay and clinical characteristics were analyzed.Results: The sensitivity and specificity of BDG were 61.5% and84.9%,and the area under the ROC curve(AUC)of BDG was 0.77.The sensitivity and specificity of GM test were 30.8% and 94.5%,and the area under the ROC curve(AUC)of GM test was 0.64.The combined sensitivity and specificity of the two tests were 80.8% and 79.8%,respectively.In IFD group,there were 4 cases of bloodstream infection,85 cases ofpulmonary infection,21 cases of digestive system infection,3 cases of intracranial infection and 18 cases of multi-system infection.The chest imaging findings were mainly dense lesions,nodules and cavities.Air crescent sign and halo sign are rare.Abdominal imaging findings were mainly nodules.Time of neutropenia over 14 d,length of hospital stay over30 d,and hypoproteinemia were independent risk factors for IFDConclusions: BDG and GM assay have limited diagnostic value in children IFD,and their combined application can improve their sensitivity.In the diagnosis of IFD in children,combined with clinical,imaging and multiple examination methods,comprehensive diagnosis is made to reduce missed diagnosis.