Survival Dynamics of Invasive Fungal Diseases in Pediatric Hemato-Oncology Patients at a Tertiary Medical Facility in Mexico from July 2020 to July 2023

Abstract

Abstract Background Invasive fungal diseases (IFD) have been increasing in prevalence over the past two decades, with filamentous fungi being the most common cause. However, candidiasis remains the predominant etiology of infection, especially in cases of neutropenic fever accompanied by neutropenic colitis. The prevalence of infections caused by Aspergillus species, Mucor species, Fusarium, and other species is higher among individuals with severe and extended neutropenia and those who have undergone hematopoietic progenitor cell transplantation. Methods A retrospective, descriptive, observational study was conducted to identify cases of patients diagnosed with invasive fungal diseases, categorizing them as possible, probable, or confirmed. In our comprehensive analysis of cases, we prioritize the examination of diseases induced by filamentous fungi, while considering the specific chemotherapy regimen administered and the particular oncological condition. Results The predominant etiology observed was invasive aspergillosis, followed by mucormycosis. A total of 18 cases suggestive of invasive Aspergillosis were identified, but clinical or histopathological investigations were not conducted due to limitations. The majority of cases were pulmonary, accounting for 92% of cases, while rhinosinusal involvement was identified in 8%. Factors such as clinical characteristics, imaging studies, serum galactomannan determination, and microbiological culture were considered. The patient survival rate was found to be 86.7%, with an average treatment duration of six weeks. A mortality rate of 3.7% was observed due to the underlying disease during the consolidation phase of invasive fungal diseases. Conclusion In our study, invasive aspergillosis emerged as the predominant invasive fungal disease in pediatric hemato-oncology patients. Despite challenges in conducting comprehensive investigations, our findings underscore the importance of timely diagnosis and management. The 86.7% survival rate reflects the efficacy of the treatment approach employed, while the observed mortality emphasizes the impact of underlying diseases on outcomes. This study contributes valuable insights to the understanding and improvement of survival dynamics in pediatric patients facing invasive fungal diseases.