| Infectious Manifestations in Childhood Leukemia |
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Yoon Jung Cho, Heung Sik Kim, Chin Moo Kang |
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Department of Pediatrics, College of Medicine, Keimyung University, Taegu, Korea |
| 소아 백혈병에서의 감염 양상 |
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조윤정, 김흥식, 강진무 |
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계명대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: Infection is one of the major causes of morbidity and mortality in children during chemotherapy
for leukemia and the development of fever in neutropenic cancer patients frequently indicates
infection. The purpose of the present study is to evaluate infectious manifestations during
the course of leukemia.
Methods
: Seventy eight leukemic children who had one or more occasions of infection during
hospitalization from January 1993 to December 1999 at Dong San Hospital, Keimyung University
were analyzed. Infection was defined clinically as a single oral temperature of 38.5℃ or higher or
as three consequent oral temperature 38℃ in a day.
Results
: Two-hundred and four febrile episodes were studied. The cause of infection was detected
in 136 episodes while in 68 episodes the cause was not detected. The causes of infection
were : 31 pneumonia, 24 sepsis, 16 urinary tract infections, 15 mucositis, and 14 wound infections.
The etiologic pathogens were identified in 53 episodes. Sixty percent of the pathogens were gram
negative organisms such as Escherichia coli, Enterobacter, Pseudomonas aeruginosa and Klebsiella.
Both gram positive and fungal infections were 17.0%. Most sensitive antibiotics were vancomycin
for gram positive organisms and ceftazidime and amikacin for gram negative organisms.
Twenty-one patients died due to FUOs, sepsis, pneumonia and severe mucositis.
Conclusion
: Infection was the most frequent cause of death in leukemic patients and fungal infections
have increased recently. The risk of infection was higher in patients with severe and
prolonged neutropenia. Therefore immediate application of antibiotics and antifungal agents will be
needed in the leukemic patient with neutropenia. |
| Key Words:
Infection, Leukemia, Childhood |
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