Surgical treatment of invasive pulmonary fungal infections in immunocompromised pediatric patients: Aspergillus spp. and other emerging fungi
Purpose Invasive Pulmonary Fungal Infections (IPFIs) represent a diagnostic and therapeutic challenge. The exact role of surgery is not well defined. This study analyzes our experience with surgical treatment of IPFI in immunocompromised pediatric patients and, secondarily, compares IPFI caused by A...
Gespeichert in:
| Veröffentlicht in: | Pediatric surgery international 2024-10, Vol.40 (1), p.263, Article 263 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 1 |
| container_start_page | 263 |
| container_title | Pediatric surgery international |
| container_volume | 40 |
| creator | López-Fernández, Sergio Molino, José Andrés Soler-Palacín, Pere Mendoza-Palomar, Natalia Uria Oficialdegui, Maria Luz Martos Rodríguez, Marta López, Manuel Guillén, Gabriela |
| description | Purpose
Invasive Pulmonary Fungal Infections (IPFIs) represent a diagnostic and therapeutic challenge. The exact role of surgery is not well defined. This study analyzes our experience with surgical treatment of IPFI in immunocompromised pediatric patients and, secondarily, compares IPFI caused by
Aspergillus
spp
.
with other fungal infections.
Methods
This is a retrospective review (2000–2019) of patients with IPFI surgically treated at our pediatric institution. Statistical analysis was used to compare data between
Aspergillus
spp. and non-
Aspergillus
IPFI.
Results
Twenty-five patients (64% female) underwent 29 lung resections. Median age at surgery was 7.19 years (1.63–19.14). The most frequent underlying condition (64%) was acute leukemia. Surgical indications included persistence or worsening of symptoms and pathological image findings (52%) or asymptomatic suspicious lesions in patients scheduled for intensive cytotoxic treatments or hematopoietic stem cell transplantation (48%). All patients underwent atypical lung resections, except one lobectomy.
Aspergillus
spp
.
was the most frequently isolated pathogen (68%). Follow-up was 4.07 years (0.07–18.07). Surgery-related mortality was 0%, but 4 patients died in the 100 days following surgery (2 due to disseminated fungal infection); the remaining 21 did not show signs of IPFI recurrence. Non-specific consolidations on CT scan were more frequent in non-
Aspergillus
IPFI (
p
|
| doi_str_mv | 10.1007/s00383-024-05851-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3113381649</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3113188557</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-a6e2d078c4c4adc660420fbdff02bef765e6b89d2cc7e0c47aff095f61e5e0a53</originalsourceid><addsrcrecordid>eNp9kU9rFTEUxYNYbK1-ARcScONmajKZZDLuSrFVKLhouw55mZtnyiQZ86fQD-F3Nu-9-gcXrnLh_HLu4R6E3lByRgkZP2RCmGQd6YeOcMlpx5-hEzqwsZskZc__mo_Ry5zvCSGSiekFOmYTE-Mk5An6cVPT1hm94JJAFw-h4GixCw86uwfAa118DDo9YlvDtmEuWDDFxZDbiJ33NUQT_ZqidxlmvMLsdEnO4FUX1-zyR3yeV2hblqVmnNf1DOsw41i-QcLgd0rY7u3dK3Rk9ZLh9dN7iu4uP91efO6uv159uTi_7kzPRem0gH4mozSDGfRshCBDT-xmtpb0G7Cj4CA2cpp7Y0YgZhh1UyZuBQUORHN2it4ffFvs7xVyUS28gWXRAWLNilHKmKRimBr67h_0PtYUWro9RaXkfGxUf6BMijknsGpNzrezKUrUrix1KEu1stS-LLVL8fbJum48zL-__GqnAewA5CaFLaQ_u_9j-xMJGqPC</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3113188557</pqid></control><display><type>article</type><title>Surgical treatment of invasive pulmonary fungal infections in immunocompromised pediatric patients: Aspergillus spp. and other emerging fungi</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>López-Fernández, Sergio ; Molino, José Andrés ; Soler-Palacín, Pere ; Mendoza-Palomar, Natalia ; Uria Oficialdegui, Maria Luz ; Martos Rodríguez, Marta ; López, Manuel ; Guillén, Gabriela</creator><creatorcontrib>López-Fernández, Sergio ; Molino, José Andrés ; Soler-Palacín, Pere ; Mendoza-Palomar, Natalia ; Uria Oficialdegui, Maria Luz ; Martos Rodríguez, Marta ; López, Manuel ; Guillén, Gabriela</creatorcontrib><description>Purpose
Invasive Pulmonary Fungal Infections (IPFIs) represent a diagnostic and therapeutic challenge. The exact role of surgery is not well defined. This study analyzes our experience with surgical treatment of IPFI in immunocompromised pediatric patients and, secondarily, compares IPFI caused by
Aspergillus
spp
.
with other fungal infections.
Methods
This is a retrospective review (2000–2019) of patients with IPFI surgically treated at our pediatric institution. Statistical analysis was used to compare data between
Aspergillus
spp. and non-
Aspergillus
IPFI.
Results
Twenty-five patients (64% female) underwent 29 lung resections. Median age at surgery was 7.19 years (1.63–19.14). The most frequent underlying condition (64%) was acute leukemia. Surgical indications included persistence or worsening of symptoms and pathological image findings (52%) or asymptomatic suspicious lesions in patients scheduled for intensive cytotoxic treatments or hematopoietic stem cell transplantation (48%). All patients underwent atypical lung resections, except one lobectomy.
Aspergillus
spp
.
was the most frequently isolated pathogen (68%). Follow-up was 4.07 years (0.07–18.07). Surgery-related mortality was 0%, but 4 patients died in the 100 days following surgery (2 due to disseminated fungal infection); the remaining 21 did not show signs of IPFI recurrence. Non-specific consolidations on CT scan were more frequent in non-
Aspergillus
IPFI (
p
< 0.05).
Conclusion
Surgical treatment of IPFI should be considered as a part of the treatment in selected pediatric immunocompromised patients, and it may have both diagnostic and therapeutic advantages over non-surgical management. When there is clinical suspicion of IPFI but CT scan shows unspecific alterations, the possibility of a non-
Aspergillus
IPFI should be considered.</description><identifier>ISSN: 1437-9813</identifier><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-024-05851-5</identifier><identifier>PMID: 39367968</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Aspergillus - isolation & purification ; Child ; Child, Preschool ; Female ; Fungal infections ; Humans ; Immunocompromised Host ; Infant ; Invasive Fungal Infections - microbiology ; Invasive Fungal Infections - surgery ; Lung Diseases, Fungal - microbiology ; Lung Diseases, Fungal - surgery ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Original Artice ; Pediatric Surgery ; Pediatrics ; Pneumonectomy - methods ; Retrospective Studies ; Stem cell transplantation ; Surgery ; Young Adult</subject><ispartof>Pediatric surgery international, 2024-10, Vol.40 (1), p.263, Article 263</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Dec 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-a6e2d078c4c4adc660420fbdff02bef765e6b89d2cc7e0c47aff095f61e5e0a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00383-024-05851-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00383-024-05851-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39367968$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>López-Fernández, Sergio</creatorcontrib><creatorcontrib>Molino, José Andrés</creatorcontrib><creatorcontrib>Soler-Palacín, Pere</creatorcontrib><creatorcontrib>Mendoza-Palomar, Natalia</creatorcontrib><creatorcontrib>Uria Oficialdegui, Maria Luz</creatorcontrib><creatorcontrib>Martos Rodríguez, Marta</creatorcontrib><creatorcontrib>López, Manuel</creatorcontrib><creatorcontrib>Guillén, Gabriela</creatorcontrib><title>Surgical treatment of invasive pulmonary fungal infections in immunocompromised pediatric patients: Aspergillus spp. and other emerging fungi</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><addtitle>Pediatr Surg Int</addtitle><description>Purpose
Invasive Pulmonary Fungal Infections (IPFIs) represent a diagnostic and therapeutic challenge. The exact role of surgery is not well defined. This study analyzes our experience with surgical treatment of IPFI in immunocompromised pediatric patients and, secondarily, compares IPFI caused by
Aspergillus
spp
.
with other fungal infections.
Methods
This is a retrospective review (2000–2019) of patients with IPFI surgically treated at our pediatric institution. Statistical analysis was used to compare data between
Aspergillus
spp. and non-
Aspergillus
IPFI.
Results
Twenty-five patients (64% female) underwent 29 lung resections. Median age at surgery was 7.19 years (1.63–19.14). The most frequent underlying condition (64%) was acute leukemia. Surgical indications included persistence or worsening of symptoms and pathological image findings (52%) or asymptomatic suspicious lesions in patients scheduled for intensive cytotoxic treatments or hematopoietic stem cell transplantation (48%). All patients underwent atypical lung resections, except one lobectomy.
Aspergillus
spp
.
was the most frequently isolated pathogen (68%). Follow-up was 4.07 years (0.07–18.07). Surgery-related mortality was 0%, but 4 patients died in the 100 days following surgery (2 due to disseminated fungal infection); the remaining 21 did not show signs of IPFI recurrence. Non-specific consolidations on CT scan were more frequent in non-
Aspergillus
IPFI (
p
< 0.05).
Conclusion
Surgical treatment of IPFI should be considered as a part of the treatment in selected pediatric immunocompromised patients, and it may have both diagnostic and therapeutic advantages over non-surgical management. When there is clinical suspicion of IPFI but CT scan shows unspecific alterations, the possibility of a non-
Aspergillus
IPFI should be considered.</description><subject>Adolescent</subject><subject>Aspergillus - isolation & purification</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Fungal infections</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Infant</subject><subject>Invasive Fungal Infections - microbiology</subject><subject>Invasive Fungal Infections - surgery</subject><subject>Lung Diseases, Fungal - microbiology</subject><subject>Lung Diseases, Fungal - surgery</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Artice</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Pneumonectomy - methods</subject><subject>Retrospective Studies</subject><subject>Stem cell transplantation</subject><subject>Surgery</subject><subject>Young Adult</subject><issn>1437-9813</issn><issn>0179-0358</issn><issn>1437-9813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9rFTEUxYNYbK1-ARcScONmajKZZDLuSrFVKLhouw55mZtnyiQZ86fQD-F3Nu-9-gcXrnLh_HLu4R6E3lByRgkZP2RCmGQd6YeOcMlpx5-hEzqwsZskZc__mo_Ry5zvCSGSiekFOmYTE-Mk5An6cVPT1hm94JJAFw-h4GixCw86uwfAa118DDo9YlvDtmEuWDDFxZDbiJ33NUQT_ZqidxlmvMLsdEnO4FUX1-zyR3yeV2hblqVmnNf1DOsw41i-QcLgd0rY7u3dK3Rk9ZLh9dN7iu4uP91efO6uv159uTi_7kzPRem0gH4mozSDGfRshCBDT-xmtpb0G7Cj4CA2cpp7Y0YgZhh1UyZuBQUORHN2it4ffFvs7xVyUS28gWXRAWLNilHKmKRimBr67h_0PtYUWro9RaXkfGxUf6BMijknsGpNzrezKUrUrix1KEu1stS-LLVL8fbJum48zL-__GqnAewA5CaFLaQ_u_9j-xMJGqPC</recordid><startdate>20241005</startdate><enddate>20241005</enddate><creator>López-Fernández, Sergio</creator><creator>Molino, José Andrés</creator><creator>Soler-Palacín, Pere</creator><creator>Mendoza-Palomar, Natalia</creator><creator>Uria Oficialdegui, Maria Luz</creator><creator>Martos Rodríguez, Marta</creator><creator>López, Manuel</creator><creator>Guillén, Gabriela</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20241005</creationdate><title>Surgical treatment of invasive pulmonary fungal infections in immunocompromised pediatric patients: Aspergillus spp. and other emerging fungi</title><author>López-Fernández, Sergio ; Molino, José Andrés ; Soler-Palacín, Pere ; Mendoza-Palomar, Natalia ; Uria Oficialdegui, Maria Luz ; Martos Rodríguez, Marta ; López, Manuel ; Guillén, Gabriela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-a6e2d078c4c4adc660420fbdff02bef765e6b89d2cc7e0c47aff095f61e5e0a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Aspergillus - isolation & purification</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Fungal infections</topic><topic>Humans</topic><topic>Immunocompromised Host</topic><topic>Infant</topic><topic>Invasive Fungal Infections - microbiology</topic><topic>Invasive Fungal Infections - surgery</topic><topic>Lung Diseases, Fungal - microbiology</topic><topic>Lung Diseases, Fungal - surgery</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Artice</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Pneumonectomy - methods</topic><topic>Retrospective Studies</topic><topic>Stem cell transplantation</topic><topic>Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>López-Fernández, Sergio</creatorcontrib><creatorcontrib>Molino, José Andrés</creatorcontrib><creatorcontrib>Soler-Palacín, Pere</creatorcontrib><creatorcontrib>Mendoza-Palomar, Natalia</creatorcontrib><creatorcontrib>Uria Oficialdegui, Maria Luz</creatorcontrib><creatorcontrib>Martos Rodríguez, Marta</creatorcontrib><creatorcontrib>López, Manuel</creatorcontrib><creatorcontrib>Guillén, Gabriela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric surgery international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>López-Fernández, Sergio</au><au>Molino, José Andrés</au><au>Soler-Palacín, Pere</au><au>Mendoza-Palomar, Natalia</au><au>Uria Oficialdegui, Maria Luz</au><au>Martos Rodríguez, Marta</au><au>López, Manuel</au><au>Guillén, Gabriela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical treatment of invasive pulmonary fungal infections in immunocompromised pediatric patients: Aspergillus spp. and other emerging fungi</atitle><jtitle>Pediatric surgery international</jtitle><stitle>Pediatr Surg Int</stitle><addtitle>Pediatr Surg Int</addtitle><date>2024-10-05</date><risdate>2024</risdate><volume>40</volume><issue>1</issue><spage>263</spage><pages>263-</pages><artnum>263</artnum><issn>1437-9813</issn><issn>0179-0358</issn><eissn>1437-9813</eissn><abstract>Purpose
Invasive Pulmonary Fungal Infections (IPFIs) represent a diagnostic and therapeutic challenge. The exact role of surgery is not well defined. This study analyzes our experience with surgical treatment of IPFI in immunocompromised pediatric patients and, secondarily, compares IPFI caused by
Aspergillus
spp
.
with other fungal infections.
Methods
This is a retrospective review (2000–2019) of patients with IPFI surgically treated at our pediatric institution. Statistical analysis was used to compare data between
Aspergillus
spp. and non-
Aspergillus
IPFI.
Results
Twenty-five patients (64% female) underwent 29 lung resections. Median age at surgery was 7.19 years (1.63–19.14). The most frequent underlying condition (64%) was acute leukemia. Surgical indications included persistence or worsening of symptoms and pathological image findings (52%) or asymptomatic suspicious lesions in patients scheduled for intensive cytotoxic treatments or hematopoietic stem cell transplantation (48%). All patients underwent atypical lung resections, except one lobectomy.
Aspergillus
spp
.
was the most frequently isolated pathogen (68%). Follow-up was 4.07 years (0.07–18.07). Surgery-related mortality was 0%, but 4 patients died in the 100 days following surgery (2 due to disseminated fungal infection); the remaining 21 did not show signs of IPFI recurrence. Non-specific consolidations on CT scan were more frequent in non-
Aspergillus
IPFI (
p
< 0.05).
Conclusion
Surgical treatment of IPFI should be considered as a part of the treatment in selected pediatric immunocompromised patients, and it may have both diagnostic and therapeutic advantages over non-surgical management. When there is clinical suspicion of IPFI but CT scan shows unspecific alterations, the possibility of a non-
Aspergillus
IPFI should be considered.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39367968</pmid><doi>10.1007/s00383-024-05851-5</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1437-9813 |
| ispartof | Pediatric surgery international, 2024-10, Vol.40 (1), p.263, Article 263 |
| issn | 1437-9813 0179-0358 1437-9813 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3113381649 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Aspergillus - isolation & purification Child Child, Preschool Female Fungal infections Humans Immunocompromised Host Infant Invasive Fungal Infections - microbiology Invasive Fungal Infections - surgery Lung Diseases, Fungal - microbiology Lung Diseases, Fungal - surgery Male Medical imaging Medicine Medicine & Public Health Original Artice Pediatric Surgery Pediatrics Pneumonectomy - methods Retrospective Studies Stem cell transplantation Surgery Young Adult |
| title | Surgical treatment of invasive pulmonary fungal infections in immunocompromised pediatric patients: Aspergillus spp. and other emerging fungi |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T10%3A28%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Surgical%20treatment%20of%20invasive%20pulmonary%20fungal%20infections%20in%20immunocompromised%20pediatric%20patients:%20Aspergillus%20spp.%20and%20other%20emerging%20fungi&rft.jtitle=Pediatric%20surgery%20international&rft.au=L%C3%B3pez-Fern%C3%A1ndez,%20Sergio&rft.date=2024-10-05&rft.volume=40&rft.issue=1&rft.spage=263&rft.pages=263-&rft.artnum=263&rft.issn=1437-9813&rft.eissn=1437-9813&rft_id=info:doi/10.1007/s00383-024-05851-5&rft_dat=%3Cproquest_cross%3E3113188557%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3113188557&rft_id=info:pmid/39367968&rfr_iscdi=true |