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MINERVA PEDIATRICA

A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry


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Minerva Pediatrica 2006 June;58(3):319-24

language: English

Sinopulmonary aspergillosis in children with hematological malignancy

Gulen H. 1, Erbay A. 2, Gulen F. 3, Kazanci E. 2, Vergin C. 2, Demir E. 3, Tanac R. 3

1 Division of Pediatric Hematology Department of Pediatrics Celal Bayar University Faculty of Medicine Manisa, Turkey
2 Clinic of Hematology and Oncology Dr. Behçet Uz Children’s Hospital Izmir, Turkey
3 Division of Pediatric Allergy and Pulmonology Department of Pediatrics Ege University Faculty of Medicine, Izmir, Turkey


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Invasive pulmonary aspergillosis is a serious infectious complication in immunocompromised especially neutropenic patients. Despite improvements in early diagnosis and effective treatment, invasive pulmonary aspergillosis is still a devastating opportunistic infection. These infections also interfere with the anticancer treatment. We report our experience in the diagnosis and therapeutic management of sinopulmonary aspergillosis in 4 children with hematologic malignancy. All patients except the first were neutropenic when sinopulmonary aspergillosis was diagnosed. Clinical signs included fever, cough, respiratory distress, swallowing difficulty, headache, facial pain-edema and hard palate necrosis. Radiodiagnostic methods showed bilateral multiple nodular infiltrations, soft tissue densities filling all the paranasal sinuses, and bronchiectasis. Diagnosis of aspergillosis was established by bronchoalveolar lavage in one case, tissue biopsy, positive sputum and positive cytology, respectively, in the other 3 cases. One patient was treated with liposomal amphotericin B and other 3 cases were treated with liposomal amphotericin B + itraconozole. Outcome was favorable in all cases except the one who died due to respiratory failure. Early diagnosis, appropriate treatment and primary disease status are important factors on prognosis of Aspergillus infections in children with hematological malignancy.

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