SEPTICEMIA DUE TO VIRIDANS STREPTOCOCCI I N CHILDREN WITH MALIGNANT HEMATOLOGIC DISEASES

This is a review of the symptoms and signs of children with malignant diseases and septicemia due to viridans streptococci, treated during a 6-year-period (1990-1995) in the Departments of Pediatrics or Pediatr ic Surgery, University of Leipzig. All 11 children suffered from leuke mia. Streptococcus mitis was the most frequently isolated streptococca l species. All patients had fever and malaise, in most cases we could find inflammatory signs of the respiratory tract. In two children we s aw a severe course of the disease, one child had symptoms and signs of ARDS, the other died on septicemic shock. All 11 patients had neutrop enia and a central venous line, 10 of them were treated by cytarabine before the streptococcal infection was diagnosed. Like others we could note during the last years an increase of systemic infections due to viridans streptococci in neutropenic patients with malignant diseases. Possibly there is an association between streptococcal infection and cytarabine therapy. The empiric antibiotic therapy in neutropenic pati ents with malignant diseases should cover also streptococcal infection s.