Central nervous system fungal infections in children with leukemia and undergoing hematopoietic stem cell transplantation: A retrospective multicenter study

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dc.contributor.authorKaraman, Serap
dc.contributor.authorKebudi, Rejin
dc.contributor.authorKızılocak, Hande
dc.contributor.authorKarakaş, Zeynep
dc.contributor.authorDemirağ, Bengü
dc.contributor.authorEvim, Melike Sezgin
dc.contributor.authorYaralı, Neşe
dc.contributor.authorKaya, Zühre
dc.contributor.authorKaragün, Barbaros Şahin
dc.contributor.authorAydoğdu, Selime
dc.contributor.authorÇalışkan, Ümran
dc.contributor.authorAyhan, Aylin Canbolat
dc.contributor.authorBahadır, Ayşenur
dc.contributor.authorÇakır, Betül
dc.contributor.authorGüner, Burçak T.
dc.contributor.authorAlbayrak, Canan
dc.contributor.authorKarapınar, Deniz Yılmaz
dc.contributor.authorKazancı, Elif Güner
dc.contributor.authorÜnal, Ekrem
dc.contributor.authorTürkkan, Emine
dc.contributor.authorAkıcı, Ferhan
dc.contributor.authorBor, Özcan
dc.contributor.authorVural, Sema
dc.contributor.authorYılmaz, Şebnem
dc.contributor.authorApak, Hilmi
dc.contributor.authorBaytan, Birol
dc.contributor.authorTahta, Neryal Müminoğlu
dc.contributor.authorGüzelküçük, Zeliha
dc.contributor.authorKoçak, Ülker
dc.contributor.authorAntmen, Bülent
dc.contributor.authorTokgöz, Hüseyin
dc.contributor.authorFışgın, Tunç
dc.contributor.authorÖzdemir, Nihal
dc.contributor.authorGüneş, Adalet Meral
dc.contributor.authorVergin, Canan
dc.contributor.authorÜnüvar, Ayşegül
dc.contributor.authorÖzbek, Namık
dc.contributor.authorTuğcu, Deniz
dc.contributor.authorBay, Sema Büyükkapu
dc.contributor.authorTanyıldız, Hikmet Gülşah
dc.contributor.authorCelkan, Tiraje
dc.date.accessioned2022-09-06T07:27:06Z
dc.date.available2022-09-06T07:27:06Z
dc.date.issued2022en_US
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalıen_US
dc.description.abstractBackground: Central nervous system fungal infections (CNSFI) are seen in patients with hematologic malignancies and have high morbidity and mortality. Because of their rarity, there is limited data on CNSFI in children with no established treatment protocols or guidelines. Materials and methods: In this multicenter retrospective study, 51 pediatric patients with leukemia, 6 of whom had undergone bone marrow transplantation, with proven or probable CNSFI were evaluated. Fungal infections were defined as proven or probable based on European Organisation for Research and Treatment of Cancer criteria. Proven CNSFI was diagnosed by appropriate central nervous system (CNS) imaging or tissue sample findings in combination with positive microbiological results of cerebrospinal fluid. A positive culture, microscopic evidence of hyphae, a positive result of the galactomannan assays are defined as positive microbiological evidence. Probable CNSFI was defined as appropriate CNS imaging findings together with proven or probable invasive fungal infections at another focus without CNS when there is no other explanatory condition. Data was collected by using the questionnaire form (Supplemental Digital Content 1, http://links.lww.com/JPHO/A541). Results: Seventeen patients had proven, 34 patients had probable CNSFI. Headaches and seizures were the most common clinical findings. The median time between the onset of fever and diagnosis was 5 days. The most common fungal agent identified was Aspergillus. Sixteen patients received single-agent, 35 received combination antifungal therapy. Surgery was performed in 23 patients. Twenty-two patients (43%) died, 29 of the CNSFI episodes recovered with a 20% neurological sequelae. Conclusion: CNSFIs should be considered in the differential diagnosis in patients with leukemia and refractory/recurrent fever, headache, neurologicalocular symptoms, and a radiologic-serological evaluation should be performed immediately. Early diagnosis and prompt management, both medical and surgical, are essential for improving clinical outcomes.en_US
dc.identifier.citationKaraman, S., Kebudi, R., Kızılocak, H., Karakaş, Z., Demirağ, B., Evim, M. S., Yaralı, N., Kaya, Z., Karagün, B. Ş., Aydoğdu, S., Çalışkan, Ü., Ayhan, A. C., Bahadır, A., Çakır, B., Güner, B. T., Albayrak, C., Karapınar, D. Y., Kazancı, E. G., Ünal, E., Türkkan, E., Akıcı, F., Bor, Ö., Vural, S., Yılmaz, Ş., Apak, H., Baytan, B., Tahta, N. M., Güzelküçük, Z., Koçak, Ü., Antmen, B., Tokgöz, H., Fışgın, T., Özdemir, N., Güneş, A. M., Vergin, C., Ünüvar, A., Özbek, N., Tuğcu, D., Bay, S. B., Tanyıldız, H. G., Celkan, T. (2022). Central nervous system fungal infections in children with leukemia and undergoing hematopoietic stem cell transplantation: A retrospective multicenter study. Journal of Pediatric Hematology/ Oncology.en_US
dc.identifier.scopus2-s2.0-85140932665
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://hdl.handle.net/20.500.12939/2957
dc.identifier.wosWOS:000874691500018
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAydoğdu, Selime
dc.institutionauthorFışgın, Tunç
dc.language.isoen
dc.relation.ispartofJournal of Pediatric Hematology/ Oncology
dc.relation.isversionof10.1097/MPH.0000000000002499en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCentral Nervous Systemen_US
dc.subjectFungal Infectionsen_US
dc.subjectLeukemiaen_US
dc.subjectPediatricsen_US
dc.titleCentral nervous system fungal infections in children with leukemia and undergoing hematopoietic stem cell transplantation: A retrospective multicenter study
dc.typeArticle

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