TY - JOUR
TI - Enteroviral infections in children with malignant disease: A 5-year
study in a single institution
AU - Moschovi, Maria A.
AU - Katsibardi, Katerina
AU - Theodoridou, Maria and
AU - Michos, Athanassios G.
AU - Tsakris, Athanassios
AU - Spanakis, Nikolaos
AU - and Tzortzatou-Stathopoulou, Fotini
JO - Journal of Infection
PY - 2007
VL - 54
TODO - 4
SP - 387-392
PB - W B SAUNDERS CO LTD
SN - 0163-4453
TODO - 10.1016/j.jinf.2006.07.002
TODO - enterovirus; childhood malignancy; leukemia; lymphoid malignancy;
hemophagocytic syndrome; treatment; immunoglobulins; outcome
TODO - Objectives: The clinical presentation, severity and outcome of
enteroviral infections in children with malignancy were studied.
Methods: All cases of enteroviral infections in a University Pediatric
Hematology-Oncology Unit were assessed, during a 5-year period. RT-PCR,
immunohistochemistry and indirect immunofluorescence assay were
performed to document the enteroviral infection and the type of virus.
Results: Fifty-five children had documented enteroviral infection among
104 patients evaluated for possible enteroviral infection. Severe
manifestations occurred in 11/55 (20%) patients, such as encephalitis
5/55, cardiac involvement 3/55 (1/55 myocarditis, 1/55 dilated
cardiomyopathy, 1/55 ventricular fibrillation) and infection associated
hemophagocytic syndrome 3/55. Children with lymphoid malignancy had
increased incidence of enteroviral infections (87%) compared to
children with solid tumors (13%). All patients received supportive
care, intravenous immunoglobulin (IVIG) (30/55 tow dose 400 mg/kg or
25/55 high dose 2 gr/kg) and/or pleconaril (2/55). All patients who
received high dose of IVIG developed early negative viral toad. However,
4 of them succumbed. Infection related fatality rate was 14.5% (N = 8).
Conclusions: Enteroviruses caused more severe and lethal manifestations
especially in children with lymphoid malignancy. The administration of
high dose of IVIG was beneficial in viremia. Thus, the early therapeutic
intervention with high dose of IVIG may improve the outcome. (c) 2006
The British Infection Society. Published by Elsevier Ltd. All rights
reserved.
ER -