Hematolojik Malignansili Pediatrik Febril Nötropeni Olgularında Invazif Fungal Enfeksiyonun Erken Tanısında Serum Galaktomannanın Yeri

Abstract

Early diagnosis and treatment of invasive fungal infections (IFI) that are causes of high morbidity and mortality rate is very important. In this study, we aimed to investigate the place of serum Platelia® Aspergillus galactomannnan (GM) EIA test in the early diagnosis of IFI. Seventy-five febrile neutropenia episodes of 55 patients with hematologic malignancy who were hospitalized because of febrile neutropenia between October 2011 and October 2012 at Hacettepe University Children's Hospital were observed. On the first, third, fifth, seventh day of the episodes, and twice a week during the risky period, a total of 417 serum samples were taken and the GM test was performed. In our study, among 27 episodes with IFI, 2(%7.4) was proven, 12 (%44.4) probable and 13(%48.1) was possible IFI. When at least 2 GM values equal to or higher than the threshold were considered positive, the sensitivity, specifity, positive predictive value and negative predictive value of GM test in the diagnosis of IFI was % 55.6, % 97.9, % 93.7 and % 79, respectively. There was statistically significant correlation between GM positivity and age distribution, duration of neutropenia and fever and the last chemoteraphy agents used (p<0.05). The highest number of GM positivity in the first week was detected on the first day (%32.7). Among 28 episodes, 21 (%75) had positive thorax BT findings and the highest GM values were on the first day. The episodes both with GM positivity and positive thorax BT findings, the highest GM values were detected on the 5th day. These findings suggest that making GM evaluation frequently at the early period of the febrile neutropenic children with hematologic malignancy will be useful for earlier diagnosis of IFI.