AUTOPSY-CONFIRMED
DEEP FUNGAL INFECTION IN CHILDREN: ANALYSIS OF 18 CASES
Yin J, Shen
KL, He LJ, Jiang ZF.
Beijing
Children's Hospital, Beijing, China
Objective The study
aimed at understanding the clinical and pathological characteristics of deep
fungal infection in autopsy confirmed cases in our hospital. Methods Between Feb.1983 and
Oct.1999, 18 cases of deep mycosis were identified out of 1000 consecutive
necropsies. Pathologic diagnosis was made based on hematoxillin and eosin
(HE) and special stainings such as PAS and hexamine silver. Under the
microscope, the hyphae and/or spores could be seen in various tissues. In
addition, the authors also reviewed the clinical records
Results The total
rate of autopsy detection of deep mycosis was 1.8% (18/1000); it was 1.4%
(13/964) between Feb.1983 and Dec.1996; but during recent 3 years, it
increased to 14% (5/36). Necropsies of the 18 cases indicated that only one
organ was affected in 7 cases, whereas 2 or more organs were affected in 11
cases. The species of fungi included aspergillus, candida, and
mucormycosis. Pulmonary involvement was reported in 14 case, followed by
the gastrointestinal, kidney, liver, brain and various other organs.
Sixteen cases had complete records, their initial clinical diagnoses
included sepsis, pneumonia, tuberculosis malignancy, et al. The clinical
manifestations included fever, cough, dyspnea, vomiting, diarrhea and
seizure. All the 16 cases were treated with antibiotics; corticosteroids
were used in 11 cases and chemotherapy was applied for 2 cases.
Conclusions The morbidity of deep mycosis has been
increasing in recent years. The conditions known to predispose deep mycosis
included cytotoxic drug, corticosteriods, prolonged antibiotic
administration or severe underlying diseases. The lung was the most
commonly affected organ. The yield of fungal culture was low.