Clinical Features and Prognosis of Invasive Pulmonary Aspergillosis in Korean Children with Hematologic/Oncologic Diseases
Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic d...
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| Published in | Journal of Korean medical science Vol. 30; no. 8; pp. 1121 - 1128 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
The Korean Academy of Medical Sciences
01.08.2015
대한의학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1011-8934 1598-6357 1598-6357 |
| DOI | 10.3346/jkms.2015.30.8.1121 |
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| Abstract | Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic diseases. Medical records of children with hematologic/oncologic diseases receiving antifungal therapy were reviewed. The enrolled children were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. During the study period, 265 courses of antifungal therapy were administered to 166 children. Among them, two (0.8%) episodes of proven IPA, 35 (13.2%) of probable IPA, and 52 (19.6%) of possible IPA were diagnosed. More children in the IPA group suffered from neutropenia lasting for more than two weeks (51.4% vs. 21.9%, P<0.001) and showed halo signs on the chest computed tomography (78.4% vs. 40.7%, P<0.001) than in the non-IPA group. No other clinical factors showed significant differences between the two groups. Amphotericin B deoxycholate was administered as a first line antifungal agent in 33 (89.2%) IPA group episodes, and eventually voriconazole was administered in 27 (73.0%) episodes. Ten (27.0%) children in the IPA group died within 12 weeks of antifungal therapy. In conclusion, early use of chest computed tomography to identify halo signs in immunocompromised children who are expected to have prolonged neutropenia can be helpful for early diagnosis of IPA and improving prognosis of children with IPA. |
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| AbstractList | Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic diseases. Medical records of children with hematologic/oncologic diseases receiving antifungal therapy were reviewed. The enrolled children were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. During the study period, 265 courses of antifungal therapy were administered to 166 children. Among them, two (0.8%) episodes of proven IPA, 35 (13.2%) of probable IPA, and 52 (19.6%) of possible IPA were diagnosed. More children in the IPA group suffered from neutropenia lasting for more than two weeks (51.4% vs. 21.9%, P<0.001) and showed halo signs on the chest computed tomography (78.4% vs. 40.7%, P<0.001) than in the non-IPA group. No other clinical factors showed significant differences between the two groups. Amphotericin B deoxycholate was administered as a first line antifungal agent in 33 (89.2%) IPA group episodes, and eventually voriconazole was administered in 27 (73.0%) episodes. Ten (27.0%) children in the IPA group died within 12 weeks of antifungal therapy. In conclusion, early use of chest computed tomography to identify halo signs in immunocompromised children who are expected to have prolonged neutropenia can be helpful for early diagnosis of IPA and improving prognosis of children with IPA. Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic diseases. Medical records of children with hematologic/oncologic diseases receiving antifungal therapy were reviewed. The enrolled children were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. During the study period, 265 courses of antifungal therapy were administered to 166 children. Among them, two (0.8%) episodes of proven IPA, 35 (13.2%) of probable IPA, and 52 (19.6%) of possible IPA were diagnosed. More children in the IPA group suffered from neutropenia lasting for more than two weeks (51.4% vs. 21.9%, P < 0.001) and showed halo signs on the chest computed tomography (78.4% vs. 40.7%, P < 0.001) than in the non-IPA group. No other clinical factors showed significant differences between the two groups. Amphotericin B deoxycholate was administered as a first line antifungal agent in 33 (89.2%) IPA group episodes, and eventually voriconazole was administered in 27 (73.0%) episodes. Ten (27.0%) children in the IPA group died within 12 weeks of antifungal therapy. In conclusion, early use of chest computed tomography to identify halo signs in immunocompromised children who are expected to have prolonged neutropenia can be helpful for early diagnosis of IPA and improving prognosis of children with IPA. KCI Citation Count: 5 Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic diseases. Medical records of children with hematologic/oncologic diseases receiving antifungal therapy were reviewed. The enrolled children were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. During the study period, 265 courses of antifungal therapy were administered to 166 children. Among them, two (0.8%) episodes of proven IPA, 35 (13.2%) of probable IPA, and 52 (19.6%) of possible IPA were diagnosed. More children in the IPA group suffered from neutropenia lasting for more than two weeks (51.4% vs. 21.9%, P <0.001) and showed halo signs on the chest computed tomography (78.4% vs. 40.7%, P <0.001) than in the non-IPA group. No other clinical factors showed significant differences between the two groups. Amphotericin B deoxycholate was administered as a first line antifungal agent in 33 (89.2%) IPA group episodes, and eventually voriconazole was administered in 27 (73.0%) episodes. Ten (27.0%) children in the IPA group died within 12 weeks of antifungal therapy. In conclusion, early use of chest computed tomography to identify halo signs in immunocompromised children who are expected to have prolonged neutropenia can be helpful for early diagnosis of IPA and improving prognosis of children with IPA. Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic diseases. Medical records of children with hematologic/oncologic diseases receiving antifungal therapy were reviewed. The enrolled children were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. During the study period, 265 courses of antifungal therapy were administered to 166 children. Among them, two (0.8%) episodes of proven IPA, 35 (13.2%) of probable IPA, and 52 (19.6%) of possible IPA were diagnosed. More children in the IPA group suffered from neutropenia lasting for more than two weeks (51.4% vs. 21.9%, P<0.001) and showed halo signs on the chest computed tomography (78.4% vs. 40.7%, P<0.001) than in the non-IPA group. No other clinical factors showed significant differences between the two groups. Amphotericin B deoxycholate was administered as a first line antifungal agent in 33 (89.2%) IPA group episodes, and eventually voriconazole was administered in 27 (73.0%) episodes. Ten (27.0%) children in the IPA group died within 12 weeks of antifungal therapy. In conclusion, early use of chest computed tomography to identify halo signs in immunocompromised children who are expected to have prolonged neutropenia can be helpful for early diagnosis of IPA and improving prognosis of children with IPA.Invasive pulmonary aspergillosis (IPA) is the most frequent form of invasive fungal diseases in immunocompromised patients. However, there are only a few studies on IPA in immunocompromised children in Korea. This study was designed to characterize IPA in Korean children with hematologic/oncologic diseases. Medical records of children with hematologic/oncologic diseases receiving antifungal therapy were reviewed. The enrolled children were divided into the IPA group (proven and probable IPA) and non-IPA group, and the clinical characteristics and prognosis were compared between the two groups. During the study period, 265 courses of antifungal therapy were administered to 166 children. Among them, two (0.8%) episodes of proven IPA, 35 (13.2%) of probable IPA, and 52 (19.6%) of possible IPA were diagnosed. More children in the IPA group suffered from neutropenia lasting for more than two weeks (51.4% vs. 21.9%, P<0.001) and showed halo signs on the chest computed tomography (78.4% vs. 40.7%, P<0.001) than in the non-IPA group. No other clinical factors showed significant differences between the two groups. Amphotericin B deoxycholate was administered as a first line antifungal agent in 33 (89.2%) IPA group episodes, and eventually voriconazole was administered in 27 (73.0%) episodes. Ten (27.0%) children in the IPA group died within 12 weeks of antifungal therapy. In conclusion, early use of chest computed tomography to identify halo signs in immunocompromised children who are expected to have prolonged neutropenia can be helpful for early diagnosis of IPA and improving prognosis of children with IPA. |
| Author | Kang, Jin Han Lee, Dong-Gun Im, Soo Ah Lee, Hyun Sil Yoon, Jong-Seo Cho, Bin Kim, Hack-Ki Han, Seung Beom Chung, Nack-Gyun Bae, E Young Jeong, Dae Chul Lee, Jae Wook Kim, Seong koo |
| AuthorAffiliation | 4 Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea 5 Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea 2 Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea 3 Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea 1 Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea |
| AuthorAffiliation_xml | – name: 3 Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea – name: 1 Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea – name: 2 Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea – name: 4 Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea – name: 5 Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea |
| Author_xml | – sequence: 1 givenname: Seung Beom orcidid: 0000-0002-1299-2137 surname: Han fullname: Han, Seung Beom organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 2 givenname: Seong koo orcidid: 0000-0002-1860-3067 surname: Kim fullname: Kim, Seong koo organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 3 givenname: E Young orcidid: 0000-0003-2777-210X surname: Bae fullname: Bae, E Young organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 4 givenname: Jae Wook orcidid: 0000-0002-0735-0287 surname: Lee fullname: Lee, Jae Wook organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 5 givenname: Jong-Seo orcidid: 0000-0002-5782-6175 surname: Yoon fullname: Yoon, Jong-Seo organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 6 givenname: Nack-Gyun orcidid: 0000-0003-4855-390X surname: Chung fullname: Chung, Nack-Gyun organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 7 givenname: Bin orcidid: 0000-0001-6675-695X surname: Cho fullname: Cho, Bin organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 8 givenname: Dae Chul orcidid: 0000-0003-0934-817X surname: Jeong fullname: Jeong, Dae Chul organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 9 givenname: Jin Han orcidid: 0000-0003-1610-6742 surname: Kang fullname: Kang, Jin Han organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 10 givenname: Hack-Ki orcidid: 0000-0001-7298-4596 surname: Kim fullname: Kim, Hack-Ki organization: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea., Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 11 givenname: Dong-Gun orcidid: 0000-0003-4655-0641 surname: Lee fullname: Lee, Dong-Gun organization: Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea., Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea., Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 12 givenname: Hyun Sil orcidid: 0000-0001-8695-9113 surname: Lee fullname: Lee, Hyun Sil organization: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea – sequence: 13 givenname: Soo Ah orcidid: 0000-0002-1264-3690 surname: Im fullname: Im, Soo Ah organization: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea |
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| SubjectTerms | Antifungal Agents - therapeutic use Child Child Health - statistics & numerical data Comorbidity Female Hematologic Diseases - mortality Humans Incidence Invasive Pulmonary Aspergillosis - diagnosis Invasive Pulmonary Aspergillosis - drug therapy Invasive Pulmonary Aspergillosis - mortality Male Neoplasms - mortality Original Prognosis Republic of Korea - epidemiology Risk Factors Survival Rate Tomography, X-Ray Computed - statistics & numerical data Treatment Outcome 의학일반 |
| Title | Clinical Features and Prognosis of Invasive Pulmonary Aspergillosis in Korean Children with Hematologic/Oncologic Diseases |
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