Invasive fungal infections in children with cancer and febrile neutropenia, in Chile

Background: Invasive fungal infections (IFI) cause prolonged hospitalizations and increase the possibility of death among patients with cancer and febrile neutropenia (FN). Up to 10% of febrile neutropenic episodes may be caused by IFI Aim: To estimate the incidence of IFI among a large group of Chilean children with cancer and FN. Patients and Methods: Clinical and laboratory information was collected from a data base provided by the "Programa Infantil Nacional de Drogas Antineoplasicas" (PINDA) that included 445 FN episodes occurring ill five hospitals ill Santiago, Chile. This information was used to identify children that presented with signs and symptoms compatible with an IFI According to predefined criteria based on a literature review IFI episodes were categorized as "Proven", "probable" or "possible". Results: A total of 411445 episodes (9-2%) were compatible with all IN of which 4 (0.9%) were proven, 23 (5.2%) probable, and 14 (3.1%) possible. Hospitalization was longer (27 vs 8 days, p < .01), new infectious foci appeared with higher frequency (71 vs 38010, p < .01), and mortality was higher (10 vs 1.6%, p < .001) in children with IFI Compatible episodes, when compared to children who did not have all IFI Conclusions: The estimated incidence of IFI in Chilean children with cancer and FN ranged between 6-9% depending oil the stringency of criteria selection used for classification. This estimate is similar to that reported by other studies. The low detection yield of clinically compatible IN underscores the need of improved diagnosis of fungal infections in this population (Rev Med Chile 2002; 130: 1139-46).