Aspergillosis in children with cancer: A 34-year experience

A retrospective review of medical records, microbiology and pathology labor atory records, and nosocomial infection surveillance data was undertaken to describe the experience with culture-documented aspergillus infection in p ediatric cancer patients at our facility. Sixty-six patients were identifie d from a 34-year period. The most common underlying diagnosis was leukemia. Risk factors included neutropenia, immunosuppression, and prior antibiotic therapy. On the basis of clinical presentation, 23 patients were believed to have disseminated disease and 43 to have localized disease. The lung was the most frequently affected organ. Despite aggressive medical and surgica l management, overall mortality was 85% within the first year after diagnos is. Patients who presented with disease in sites other than the lungs fared better than patients with initial pulmonary involvement (P = .0014). Asper gillosis continues to be associated with poor outcome. Development of impro ved medical and adjuvant therapies, including surgery, is warranted.